Incidental discovery could help diabetics with foot wounds

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CHARLOTTESVILLE, Va. (CBS19 NEWS) -- An incidental discovery in a chemistry lab has now become a project helping drug makers and doctors better heal the foot wounds of diabetes patients.

The project is the result of a bridge-building collaboration between University of Virginia researchers and clinicians at the College of Arts and Science's Department of Chemistry, the School of Engineering's Department of Biomedical Engineering, and the School of Medicine's Department of Plastic Surgery and Chronic Wound Care Clinic.

According to a release, the work began eight years ago as fundamental research by a graduate student who has since earned his Ph.D.

That student, Guoqing Zhang, was experimenting with a simple compound when he discovered it glowed under an ultraviolet lamp and has a long-lasting green afterglow.

Zhang and chemistry and biomedical engineering professor Cassandra Fraser, working with chemistry professor Jim Demas, realized the material could have commercial and medical potential.

Over the years since, more experimentation led to the creation of several variations of the compound and testing it on cells, tissues and living systems such as tumors and the brain.

Researchers eventually optimized a polymer that changes luminescence color when uncovered and exposed to air, acting as an oxygen detector.

Fraser then reached out to biomedical engineering professor Shayn Peirce-Cottler, who works in designing therapies for patients with diabetes, heart disease and musculoskeletal problems.

Due to the difficulty diabetic patients often suffer with regard to poor circulation in the legs, these patients frequently deal with difficult-to-heal open wounds on the bottoms of their feet at pressure points.

“These wounds are partly a result of oxygen deficiency in the feet because of poor blood circulation,” said Peirce-Cottler. “Physicians who treat these patients use therapies designed to increase blood circulation to the area of a wound, and thereby increase the oxygen level for better healing.”

However, there are about 73,000 amputations performed each year on diabetics with wounds that refuse to heal. About 77 percent of the diabetics who get an amputation tend to die within five years of the procedure.

The release says key to treating such wounds is figuring out early what therapies increase blood circulation to a wound site and which do not.

The researchers looked into the potential of using the polymer to non-invasively make visible the amount of oxygen at a wound site, which could help doctors better monitor and assess how well a treatment plan to improve circulation is working.

The team has developed a portable laptop camera system that when used with the light-emitting materials can make movies of dynamic tissue oxygen levels at a wound site over periods of time.

The release describes how the polymer works, saying in the presence of pure oxygen and exposed to ultraviolet light, it glows blue.

In normal air conditions, it has a grayish color, but in low-oxygen conditions, it turns yellow.

As a wound heals, the oxygen levels in the tissue increase, which with the color change of the polymer will show a treatment plan is working to help the patient.

Working with Patrick Cottler in plastic surgery, Dr. Chris Campbell, and nursing professor Catherine Ratliff, the team began experimenting with the material in pre-clinical models by applying it topically to wound sites and making real-time movies of oxygen as it flowed into or away from a wound.

They found they can map oxygen levels in wounds as they either heal or don't.

“Quickly knowing whether or not a wound is getting enough oxygen to heal is valuable information, since many diabetic ulcers lead to amputation,” said Cottler. “This can tell a doctor early in a treatment plan whether or not a given therapy to increase blood circulation is working well. If not, the treatment plan can be changed early to one that may be more effective.”

The release says the material, depending on its formulation, can be applied to a wound like an ointment and then washed off after an imaging session, with no apparent negative side effects.

The team will soon begin clinical trials for patients with chronic wounds, which will be designed to test the efficacy of the material and camera setup.

“If our technology can help doctors and nurses easily and more accurately identify which therapies are working well and which are not, they can better tailor treatments to the individual patient, potentially saving limbs from amputation and saving lives,” said Peirce-Cottler.

The release adds the material are also proving effective in displaying oxygen levels in tumors, in the brain, and for uses in immunology, microbiology and tissue engineering. Non-medical uses could include forensics.

A major pharmaceutical company has recently licensed the technology to use as a way to test the efficacy of new drugs under development for treating diabetic wounds.

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