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Prognostic Imaging and Blood Markers of Wound Healing Among Patients with Diabetic Foot Ulcers
Summary Data Summary
Applicant Reiter, David
E-Mail Address dareite@emory.edu
Project Title Prognostic Imaging and Blood Markers of Wound Healing Among Patients with
Diabetic Foot Ulcers
CBU ID 19AU4061
External SubContract ID 32307-61
Diabetic Complication Wound Healing
Funding Program Group Pilot & Feasibility [PF2019]
Abstract The objective of this proposal is to establish and translate novel noninvasive
imaging methods and blood markers prognostic of incomplete wound healing in the
setting of diabetic foot ulcers (DFU). Over 30 million people live with diabetes
in the United States. Diabetic foot ulcers (DFU) account for 25-50% of all
diabetes-related hospital costs in the US totaling approximately $40 billion per
year and are often the first recognized sign of impending limb loss. The
lifetime risk for DFU is up to 25% and its treatment is resource-intensive
requiring antibiotics, frequent wound care, and surgical procedures, yet 1-year
healing rates are only 75%. Once an ulcer forms, the risk of limb loss is high
with up to 20% of patients undergoing lower-extremity amputation. Strong basic
and clinical evidence demonstrates both initiation of ulcers and poor wound
healing arise from reduced tissue perfusion and ischemia. Diminished oxidative
capacity in circulating immune cells have been implicated in disease states
associated with poor wound healing. Currently there are no effective clinical
tools for predicting DFU. With the long-term goal of improving the clinical
outcomes, we will examine the influence of microvascular impairment and reduced
immune cell energetics on wound healing in patients with DFU. In human subjects,
we have demonstrated both robust in vivo magnetic resonance imaging approaches
for quantifying resting tissue perfusion and microvascular reserve. We have also
demonstrated the ability to measure reductions in monocyte reserve respiratory
capacity in obesity compared with normal weight human subjects. With this
technical foundation established, the proposed study will extend these methods
for improved characterization of incomplete wound repair in diabetic foot
ulcers. In this pilot study, we will pursue two related specific aims. In Aim 1,
we will establish MRI measurements to characterize microcirculatory
abnormalities in patients with diabetic foot ulcers. In Aim 2, we will test for
reduced monocyte reserve respiratory capacity in patients with diabetic foot
ulcers. If successful, this work will establish proof-of-principle data for the
use of imaging and blood markers to assess diminished microcirculatory and
immune cellular energetic capacity in the setting of DFU. The results from this
pilot study are expected to provide important data on measurement sensitivity to
support the design of follow-up longitudinal work to examine and disentangle the
combined and/or independent influences of microcirculatory and energetic
impairment in DFU patients that exhibit incomplete wound repair; this will form
the basis of an R-level NIH proposal. Ultimately, we expect this will provide
novel information for more effective treatment strategies of DFU and allow for
improved patient selection for trials evaluating novel DFU wound healing
therapies.
Application PDF Application Research Plan
Status Contract Executed
Key Personnel Jessica Alvarez
Marcos Coutinho Schechter
Maya Fayfman
Ravi Rajani
Benjamin Risk
Salary Total Costs 42014
Supply Total Costs 4000
Equipment Total Costs 0
Travel/Other Total Costs 17460
Direct Costs 63474
Indirect Costs Proposed 35545
Total Costs Proposed 99019
Total Costs Approved 99019
Start Date 11/1/2019
End Date 10/31/2021
IFO Name
IFO E-Mail Address
IACUC/IRB No. 99999
IACUC/IRB Institution Emory University
Entity ID No.
Report Request Date 11/29/2021
T1D NO
TypeCount
Invoices 19
Progress Reports 2
Experiments 1
Data Submission


Invoices
UrlCBU IDExternal IDInstitutionDateDirectIndirectInvoiceBalancePDF
  View  19AU406132307-61Emory University9/24/2020$3,542.46$1,983.76$5,526.22$791.90View PDF
  View  19AU406132307-61Emory University8/16/2021$2,021.87$1,132.24$3,154.11$791.90View PDF
  View  19AU406132307-61Emory University8/11/2020$4,051.57$2,268.88$6,320.45$791.90View PDF
  View  19AU406132307-61Emory University7/20/2020$3,200.23$1,792.12$4,992.35$791.90View PDF
  View  19AU406132307-61Emory University7/16/2021$3,454.20$1,934.35$5,388.55$791.90View PDF
  View  19AU406132307-61Emory University6/24/2020$3,221.51$1,804.04$5,025.55$791.90View PDF
  View  19AU406132307-61Emory University6/16/2021$2,639.62$1,747.57$4,387.19$791.90View PDF
  View  19AU406132307-61Emory University5/21/2020$5,255.76$2,943.23$8,198.99$791.90View PDF
  View  19AU406132307-61Emory University5/16/2021$3,552.38$1,719.97$5,272.35$791.90View PDF
  View  19AU406132307-61Emory University4/9/2021$2,464.39$1,380.06$3,844.45$791.90View PDF
  View  19AU406132307-61Emory University4/29/2020$2,846.33$1,593.93$4,440.26$791.90View PDF
  View  19AU406132307-61Emory University3/9/2021$4,360.92$2,442.08$6,803.00$791.90View PDF
  View  19AU406132307-61Emory University3/10/2020$4,412.27$2,470.85$6,883.12$791.90View PDF
  View  19AU406132307-61Emory University2/9/2021$2,105.18$1,178.89$3,284.07$791.90View PDF
  View  19AU406132307-61Emory University12/9/2020$2,533.85$1,418.95$3,952.80$791.90View PDF
  View  19AU406132307-61Emory University12/3/2021$4,532.93$2,538.55$7,071.48$791.90View PDF
  View  19AU406132307-61Emory University11/19/2020$3,618.20$2,026.19$5,644.39$791.90View PDF
  View  19AU406132307-61Emory University10/9/2020$3,399.11$1,903.51$5,302.62$791.90View PDF
  View  19AU406132307-61Emory University1/12/2021$1,753.31$981.84$2,735.15$791.90View PDF


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