The finding, published online Dec. 14th in the International Wound Journal, represents an unappreciated link that could lead to important new insights in wound healing, say researchers at Georgetown University Medical Center. (Data from this study were presented at the 2011 annual meeting of the American College of Rheumatology.)
The study was sparked by the keen observation of Georgetown rheumatologist Victoria Shanmugam, M.D., who began noticing something rather unusual in her patients with autoimmune diseases — any open wound they had was very slow to heal. Their recovery was even more protracted than in patients with wounds who have diabetes, a disease that is notoriously damaging to blood vessels and to normal skin repair.
So Shanmugam and her colleagues conducted a chart review of people who sought care at a high-volume wound clinic at Georgetown University Hospital to determine the prevalence of autoimmune diseases. The study included patients with open wounds — usually leg ulcers who were treated during a three-month period in 2009. Of the 340 patients, 49 percent had diabetes, which she says is a typical rate.
"But what was surprising is that 23 percent had underlying autoimmune diseases, and the connection between these relatively rare disorders and wounds that don't heal is under-recognized," she says.
Of the 78 patients in the cohort who had autoimmune disease, most had rheumatoid arthritis, lupus or livedoid vasculopathy, a type of vascular disease.
Shanmugam says her findings also show that autoimmune disease-associated wounds were significantly larger at the patient's first visit. These non-healing wounds can be "incredibly emotionally draining and financially costly," Shanmugam says, because they require doctor visits over many months as well as an ever-present risk of serious infections. Sometimes, infections can lead to surgery and the amputation of limbs. More often, they require skin grafts or use of skin substitutes, which may still not solve the problem.
In fact, Shanmugam's study found that skin grafts were more likely to fail in patients with autoimmune disease-associated wounds.
Shanmugam hopes the link she has made between autoimmune diseases and wound healing will make its way into the consciousness of the general practitioner. While it is much too invasive and costly to recommend that all patients with wounds be tested for autoimmune diseases, she says, "If a doctor has a patient with a leg ulcer that won't heal after three or four months and they have done all the appropriate treatments, I hope they will look for the presence of an autoimmune disorder."
Shanmugam's research is funded by a KL2 Mentored Career Development Program Scholar grant from Georgetown-Howard Universities Center for Clinical & Translational Science. The Center was established in 2010 and is funded by a National Institutes of Health Clinical and Translational Science Award. The KL2 grant funds junior faculty members starting translational research programs.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization (BGRO), which accounts for the majority of externally funded research at GUMC including a Clinical Translation and Science Award from the National Institutes of Health. In fiscal year 2010-11, GUMC accounted for 85 percent of the university's sponsored research funding.
Karen Mallet | EurekAlert!
Researchers release the brakes on the immune system
18.10.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
Norovirus evades immune system by hiding out in rare gut cells
12.10.2017 | University of Pennsylvania School of Medicine
University of Maryland researchers contribute to historic detection of gravitational waves and light created by event
On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...
Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.
Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....
Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).
When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...
Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.
How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...
Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.
It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...
17.10.2017 | Event News
10.10.2017 | Event News
10.10.2017 | Event News
18.10.2017 | Materials Sciences
18.10.2017 | Physics and Astronomy
18.10.2017 | Physics and Astronomy