Impaired wound healing is an important clinical problem in diabetes resulting in failure to completely heal diabetic foot ulcers and more that 75,000 lower extremity amputations annually. Based on our extensive clinical work we have pointed to the synergistic pathophysiology of neuropathy and ischemia in creating the compromised biology of the diabetic foot. In this proposal we plan to expand our studies and further evaluate the role on nerve dysfunction in new animal models of diabetic wound healing. The main hypothesis of the current proposal is that neuropeptides play an important role in wound healing and that the lack of them due to peripheral neuropathy, combined with the diabetes-related chronic inflammation, leads to impaired angiogenesis and wound healing.
Our specific aims are: 1. To develop in vivo diabetic rabbit models for investigating cutaneous wound healing and failure to heal in the presence of multiple states: diabetes alone, diabetes with peripheral ischemia, diabetes with peripheral neuropathy, and diabetes with both peripheral ischemia and neuropathy, 2. To evaluate the wound healing progress, cytokine expression, angiogenesis and tissue oxygenation in substance P and substance P neurokinin-receptor (NK-1r), KO diabetic and non-diabetic mice. We will also evaluate the same parameters in wild type mice (diabetic and non diabetic) after combined peripheral administration of NK-1R, antagonist, and 3. To study the expression of neuropeptides at the skin level of neuropathic and non-neuropathic diabetic patients and compare it to healthy control subjects. We will also examine whether the neuropeptide expression is related to the development of foot ulceration and the failure to heal foot ulcers. These studies, from bench to bedside, will greatly advance knowledge in the broad area of wound healing and will specifically result in the development of basic and translational research data that can lead to the development of new therapeutic approaches to improve wound healing in diabetes

Public Health Relevance

Impaired wound healing is an important clinical problem in diabetes and results in failure to completely heal diabetic foot ulcers and more that 75,000 annual lower extremity amputations. The main hypothesis of the current proposal is that neuropeptides, the peptides that are secreted by the nerve fibers, play an important role in wound healing and that the lack of them due to peripheral neuropathy, combined with the diabetes- related chronic inflammation, leads to impaired angiogenesis and wound healing. We expect that the studies proposed in this protocol, from bench to bedside, will considerably enhance our knowledge and will result in the development of both basic and translational research data that can lead to the development of new therapeutical approaches to improve wound healing in diabetes.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS066205-03
Application #
8267700
Study Section
Clinical Neuroplasticity and Neurotransmitters Study Section (CNNT)
Program Officer
Gnadt, James W
Project Start
2010-06-01
Project End
2015-05-31
Budget Start
2012-06-01
Budget End
2013-05-31
Support Year
3
Fiscal Year
2012
Total Cost
$385,156
Indirect Cost
$163,802
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215
Quinn, Kyle P; Leal, Ermelindo C; Tellechea, Ana et al. (2016) Diabetic Wounds Exhibit Distinct Microstructural and Metabolic Heterogeneity through Label-Free Multiphoton Microscopy. J Invest Dermatol 136:342-344
Baltzis, Dimitrios; Bakker, Jessie P; Patel, Sanjay R et al. (2016) Obstructive Sleep Apnea and Vascular Diseases. Compr Physiol 6:1519-28
Roustit, Matthieu; Loader, Jordan; Deusenbery, Carly et al. (2016) Endothelial Dysfunction as a Link Between Cardiovascular Risk Factors and Peripheral Neuropathy in Diabetes. J Clin Endocrinol Metab 101:3401-8
Tellechea, Ana; Leal, Ermelindo C; Kafanas, Antonios et al. (2016) Mast Cells Regulate Wound Healing in Diabetes. Diabetes 65:2006-19
Leal, Ermelindo C; Carvalho, Eugénia; Tellechea, Ana et al. (2015) Substance P promotes wound healing in diabetes by modulating inflammation and macrophage phenotype. Am J Pathol 185:1638-48
Quinn, Kyle P; Leal, Ermelindo C; Tellechea, Ana et al. (2015) Diabetic Wounds Exhibit Distinct Microstructural and Metabolic Heterogeneity Through Label-Free Multiphoton Microscopy. J Invest Dermatol :
Petra, Anastasia I; Panagiotidou, Smaro; Stewart, Julia M et al. (2014) Spectrum of mast cell activation disorders. Expert Rev Clin Immunol 10:729-39
Theoharides, Theoharis C; Asadi, Shahrzad; Panagiotidou, Smaro et al. (2013) The ""missing link"" in autoimmunity and autism: extracellular mitochondrial components secreted from activated live mast cells. Autoimmun Rev 12:1136-42
Papathanasiou, E; Palaska, I; Theoharides, T C (2013) Stress hormones regulate periodontal inflammation. J Biol Regul Homeost Agents 27:621-6
Pradhan Nabzdyk, Leena; Kuchibhotla, Sarada; Guthrie, Patrick et al. (2013) Expression of neuropeptides and cytokines in a rabbit model of diabetic neuroischemic wound healing. J Vasc Surg 58:766-75.e12

Showing the most recent 10 out of 20 publications