- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02581098
miR-200b & miR-21 in Diabetic Wounds
Novel Regulators of Wound Angiogenesis and Inflammation
Study Overview
Status
Intervention / Treatment
Detailed Description
The study is designed as a 14 week prospective observational study where patients with diabetic wounds visiting the Indiana University Health Comprehensive Wound Center (CWC) will be enrolled. Patients enrolled will be followed for 14 weeks including 4 study visits, initial visit (week 0), study visit 2 (week 2), study visit 3 (week 4), and will return for a final follow-up study visit 4 (week 14; miR-200b arm only). Standardized Care Outline will be per physician discretion.
The initial visit will take place during the patients regularly scheduled CWC visit and the following will take place: informed consent will be obtained, baseline demographics and medical history with be collected, current labs and medications will be recorded, wound data will be obtained, an ankle brachial index will be completed for patients with leg wounds below the knee, if not already completed per Standard of Care (SoC) since onset of the wound, and wound photographs for digital planimetry to measure wound area. Wound fluid will be collected using a filter paper method, aspiration method, or via the NPWT (Negative Pressure Wound Therapy, also known as Wound Vac) sponge prior to debridement. Additionally, two 3 mm punch tissue biopsies will be obtained from the patient's physician; however, this is optional. If the wound shows signs of healing and does not show signs of infection (i.e. the wound has not stalled in healing for 2 or more weeks or become larger in size) or the wound has been declared healed by their physician, the biopsies will not be obtained. The study visits 2-4 will include the following: a medication and adverse event review, wound data will be recorded, wound photographs, wound fluid, and two 3 mm punch tissue biopsies will be obtained from the patient's physician.
Potential Risks:
The risks associated with this research study are low. There are no therapeutic interventions or medications as part of this study to be administered depending on the amount of sensation the subject has at the site of the wound.
If the subject is receiving a biopsy, the wound site will be numbed by applying local anesthesia as appropriate to the area being biopsied. There may be some discomfort with the tissue biopsy procedure, but all reasonable efforts will be made to minimize pain. The biopsy procedure is done within the boundaries of the existing wound to avoid giving the patient a separate new wound. Bleeding is a possible complication, but the risk is low for the small biopsies and is reduced by using local anesthetics with epinephrine, and silver nitrate sticks are available in each room to cauterize biopsy sites as needed. Infection is also a potential risk; however, wound tissue biopsies are routinely performed as the standard of care in the CWC to diagnose wound infection. The biopsy site will be appropriately monitored for infection by the physician managing the wound during routine wound clinic visits.
The ABI test may result in temporary discomfort around the ankle or foot when the cuff is inflated, but does not present any further physical or medical risks. The wound fluid collection is non-invasive and does not present any risk. Study participants will not benefit directly from participation in this study. This research information has the potential of providing considerable benefits to wound care by identifying a key player that influences the closure of chronic diabetic wounds. Such knowledge should help develop novel biomarker and or miR-directed therapeutic strategies.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Bryce Hockman, CCRP
- Phone Number: 317 278 2715
- Email: bbhockma@iu.edu
Study Contact Backup
- Name: Kaitlyn Depinet, FNP-C
- Phone Number: 317 278 2747
- Email: kdepinet@iu.edu
Study Locations
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Indiana
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Indianapolis, Indiana, United States, 46202
- IU Health Methodist Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Ages 18 and older
- Willing and able to provide informed consent
- Willing and able to comply with protocol instructions, including all biopsies and study visits
- Diabetes Mellitus
- Chronic wounds (open >30d) of any etiology
- Subjects with Negative Pressure Wound Therapy (NPWT or also called a wound vac) (Note: Applies only to the miR-21 arm)
Exclusion Criteria:
- Revascularization surgery on the target wound within 60 days prior to enrollment
- Inadequate arterial supply, as evidenced by any of the following:
- Transcutaneous Oxygen Measurement (TcOM) < 30mmg
- Ankle Brachial Index (ABI) <0.7 or 1.3
- Toe Brachial Index (TBI) <0.6
- Subjects with marked immunodeficiency (HIV/AIDS, organ transplant patients and actively being treated for cancer)
- Trauma wounds
- Wounds closed or to be closed by flap or graft coverage
- Women who are pregnant
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Wound-edge endothelial miR-200b
Time Frame: 14 weeks
|
This study aims to determine if elevated wound-edge endothelial miR-200b and attenuated wound macrophage miR-21 levels are barriers to wound healing (closure) in diabetic wounds.
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14 weeks
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Wound macrophage isolation to determine miR-21
Time Frame: 14 weeks
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To determine if ex vivo supplementation of miR-21 mimic and recombinant MFG-E8 resolve inflammation in wound macrophages isolated from Negative Pressure Wound Therapy sponges from diabetic wounds.
|
14 weeks
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Chandan K Sen, PhD, Indiana University
Publications and helpful links
General Publications
- Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TK, Gottrup F, Gurtner GC, Longaker MT. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009 Nov-Dec;17(6):763-71. doi: 10.1111/j.1524-475X.2009.00543.x.
- Roy S, Patel D, Khanna S, Gordillo GM, Biswas S, Friedman A, Sen CK. Transcriptome-wide analysis of blood vessels laser captured from human skin and chronic wound-edge tissue. Proc Natl Acad Sci U S A. 2007 Sep 4;104(36):14472-7. doi: 10.1073/pnas.0706793104. Epub 2007 Aug 29.
- Schafer M, Werner S. Transcriptional control of wound repair. Annu Rev Cell Dev Biol. 2007;23:69-92. doi: 10.1146/annurev.cellbio.23.090506.123609.
- Padberg FT, Back TL, Thompson PN, Hobson RW 2nd. Transcutaneous oxygen (TcPO2) estimates probability of healing in the ischemic extremity. J Surg Res. 1996 Feb 1;60(2):365-9. doi: 10.1006/jsre.1996.0059.
- Roy S, Khanna S, Rink C, Biswas S, Sen CK. Characterization of the acute temporal changes in excisional murine cutaneous wound inflammation by screening of the wound-edge transcriptome. Physiol Genomics. 2008 Jul 15;34(2):162-84. doi: 10.1152/physiolgenomics.00045.2008. Epub 2008 May 6.
- Chan YC, Khanna S, Roy S, Sen CK. miR-200b targets Ets-1 and is down-regulated by hypoxia to induce angiogenic response of endothelial cells. J Biol Chem. 2011 Jan 21;286(3):2047-56. doi: 10.1074/jbc.M110.158790. Epub 2010 Nov 16.
- Chan YC, Roy S, Khanna S, Sen CK. Downregulation of endothelial microRNA-200b supports cutaneous wound angiogenesis by desilencing GATA binding protein 2 and vascular endothelial growth factor receptor 2. Arterioscler Thromb Vasc Biol. 2012 Jun;32(6):1372-82. doi: 10.1161/ATVBAHA.112.248583. Epub 2012 Apr 12.
- Chin D, Boyle GM, Theile DR, Parsons PG, Coman WB. The human genome and gene expression profiling. J Plast Reconstr Aesthet Surg. 2006;59(9):902-11. doi: 10.1016/j.bjps.2006.01.008. Epub 2006 Mar 9.
- Gardner SE, Frantz RA, Doebbeling BN. The validity of the clinical signs and symptoms used to identify localized chronic wound infection. Wound Repair Regen. 2001 May-Jun;9(3):178-86. doi: 10.1046/j.1524-475x.2001.00178.x.
- Parsek MR, Singh PK. Bacterial biofilms: an emerging link to disease pathogenesis. Annu Rev Microbiol. 2003;57:677-701. doi: 10.1146/annurev.micro.57.030502.090720.
- Shilo S, Roy S, Khanna S, Sen CK. Evidence for the involvement of miRNA in redox regulated angiogenic response of human microvascular endothelial cells. Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):471-7. doi: 10.1161/ATVBAHA.107.160655. Epub 2008 Feb 7.
- Shilo S, Roy S, Khanna S, Sen CK. MicroRNA in cutaneous wound healing: a new paradigm. DNA Cell Biol. 2007 Apr;26(4):227-37. doi: 10.1089/dna.2006.0568.
- Hopf HW, Ueno C, Aslam R, Burnand K, Fife C, Grant L, Holloway A, Iafrati MD, Mani R, Misare B, Rosen N, Shapshak D, Benjamin Slade J Jr, West J, Barbul A. Guidelines for the treatment of arterial insufficiency ulcers. Wound Repair Regen. 2006 Nov-Dec;14(6):693-710. doi: 10.1111/j.1524-475X.2006.00177.x. No abstract available.
- Wutschert R, Bounameaux H. Determination of amputation level in ischemic limbs. Reappraisal of the measurement of TcPo2. Diabetes Care. 1997 Aug;20(8):1315-8. doi: 10.2337/diacare.20.8.1315.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1807426080
- GM108014/DK114718 (Other Grant/Funding Number: NIH)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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