Congrats to Steve Thom, Neil Donohue, Dave Margolis, Scot Malay and colleagues on this fascinating work. Perhaps a new theragnostic in the works?
Management of neuropathic foot ulcers in diabetic patients (DFUs) has changed little the past decade and there is currently no objective method to gauge probability of successful healing. We hypothesized that studies of stem/progenitor cells (SPCs) in the early weeks of standard wound management could predict who will heal within 16 weeks. Blood and debrided wound margins were collected for 8 weeks from 100 patients undergoing weekly evaluations and treatment. SPCs number and intracellular content of hypoxia inducible factors (HIFs) were evaluated by flow cytometry and immunohistochemistry. More SPCs entered the blood stream in the first two weeks of care in patients who healed (n=37) versus those who did not (n=63). Logistic regression demonstrated that blood-borne SPCs number and cellular content of HIFs at study entry and the first week follow-up visit predicted healing. Strong correlations were found among week-to-week assessments of blood-borne SPCs HIF factors. We conclude that assays of SPCs during the first weeks of care in patients with DFUs can provide insight into how well wounds will respond, and may aid with decisions on use of adjunctive measures.
Diabetes. 2015 Oct 20. pii: db150517. [Epub ahead of print]