Simon Palfreyman together to Manisha Gupta of the University of Alberta, have developed a biosensor capable of monitoring wounds in the diabetic foot and preventing amputation. Palfreyman is an expert in wound care and Gupta is a leader in the manufacture of biosensors that can be attached to the skin to monitor important information such as temperature or the presence of germs.
This common goal arose from the need to spare patients suffering from diabetes the amputation of the lower limbs of those affected by diabetic foot: it was Is it possible to create a biosensor that would detect and treat foot injuries before they became severe enough to require amputation?
Biosensor for diabetic foot: this is how it works
Gupta and Palfreyman have requested a collaboration a Douglas Zochodne, a neurologist and neuroscientist from the Faculty of Medicine and Dentistry, who has experience with nerve damage that turns diabetic foot injuries into dangerous, diabetic foot injuries.
The aim of the joint project is to develop and test a new biosensor that can be incorporated into a dressing or used as a swab to analyze the wound. The sensor will measure up to four variables, possibly electrolytes, temperature, pressure and glucose levels, so doctors can monitor progress, detect complications and determine precise treatments: “The main thrust is personalized medicine tailored to each patient” , Gupta explained.
“The idea is to arrive early when wounds are less complicated, cheaper and easier to treat, rather than when the wound is enlarged and does not heal, and problems such as infection are already established. “, Palfreyman intervened. “Urgent medical intervention is needed with diabetic foot wounds because they can deteriorate fairly quickly“.
Zochodne explained that diabetes can cause nerve damage known as diabetic polyneuropathy, which means some people can injure their skin or develop a severe ulcer without realizing it. Lack of nerves also slows healing: “Treating these wounds is like working at the bottom of a cave without lights on “said Zochodne, who is director of the Neuroscience & Mental Health Institute and director of the division of neurology.
“We don’t know the basic biochemistry of what’s going on in these wounds and why they don’t heal, so this enabling technology that Dr. Gupta has developed has fantastic possibilities. “.
Alberta Health Services Diabetic Foot Care Clinical Trial Phases highlighted the importance of regular foot screening for one in four residents of theAlberta who have diabetes or the pre-diabetes. More than half of people with diabetes will develop it polyneuropathy and 15 to 20% will develop foot ulcers. Unfortunately, the results are often inadequate: about three out of four patients will die within five years of having a lower limb amputated, according to Diabetes Educators Calgary.
“Existing technology does not allow for localized measurements within wounds”, Gupta said. “The novelty of this is that we are going to monitor more parameters within the real wound environment ”.
Gupta’s team of experts has previously developed biosensors to measure pressure, glucose and ion levels. Transistor-based sensors are 3D printed using biocompatible materials such as gold and organic semiconductors that work well in an aqueous environment and will not be rejected by the body’s immune system. Sensors can be as small as ten microns, about one-seventh the width of a human hair.
The new sensors for diabetic foot wounds will be developed and tested on diabetic animals and, subsequently, on human volunteers. The team is working with an industry partner, Clinysis EMR, a local data analytics company.
Gupta already has a new goal: develop an app that allows patients to monitor their wound sensors . Palfreyman said the system could be important for people living in remote communities who don’t have access to in-person clinical care.
Not only a biosensor, but also a biopolymer to heal chronic wounds
Millions of people around the world suffer from chronic injure and in addition to the importance of developing a biosensor for the diabetic foot, it was necessary to develop a practical and low-cost dressing in biopolymer to help heal these wounds.
At the head of this important project is a researcher from Michigan State University who is leading an international team: ” Existing efficient technologies are too expensive for most health systems, severely limiting their use in a timely manner “, he has declared Morteza Mahmoudi, assistant professor at the Michigan State University College of Human Medicine and the Precision Health Program. “We need an affordable, practical and effective technology. “
To be able to give life to this brilliant idea, Mahmoudi is based on years of experience and expertise, studying materials dedicated to the care of heart tissue, research on how to fight infections and support the immune system. however, the group of experts also had an eye on costs, working to develop a product that could be made available to as many patients as possible, even in markets with limited resources.
“My goal is always to do something that works and is practical”, Mahmoudi said. “I want to see my research become clinical products that help patients ”.
“We are building a team of experts in the UK who will be able to efficiently market the dressing”Mahmoudi said. “The company has just won a very competitive Eurostar grant to accelerate product development ”.
Mahmoudi and his collaborators conducted a small pilot trial of the dressing with 13 patients with chronic wounds, all healed. “Patients with advanced chronic wounds, those who do not respond to traditional therapies, are estimated to be over 45 million globally, making this one of the most urgent and urgent health needs in the world“Said Mahmoudi.
Venous leg ulcers and pressure ulcers associated with immobility in older and paralyzed patients are also leading causes of chronic wounds, as well as diabetic foot ulcers for which an effective biosensor has already been developed. Diabetic foot ulcers hint at why many of the reasons chronic wounds can be so difficult to treat.
Patients with diabetes may have to deal with limited blood flow, and other factors that slow their immune response, compromising the body’s ability to heal the wound on its own. They may also have nerve damage that lessens wound pain and can delay patients from seeking treatment. When wounds heal slower and stay open longer, bacteria have a greater chance of causing infections and leading to serious complications. Put simply, there are many things wrong with a chronic wound.
“Chronic wounds are some of the most complicated things doctors have to treat“Explained Mahmoudi. “If you want to make a dressing that works, it has to deal with all these problems. And to be relevant to most patients around the world, it must also be easy to use, practical and inexpensive. “
Another Mahmoudi goal is to bring an affordable technology to life, by designing a product that can be manufactured from readily available biopolymers, manufacturing costs can be kept low, and the team could add various other materials to lead to better healing.
The study team exploited a flexible structure of nanofibers, extremely fine strands of natural polymers, including collagen, a structural support protein found in our skin and cartilage. The structure provides a three-dimensional scaffolding that promotes cell migration and the development of new blood vessels, essentially replicating the function of the extracellular matrix, the natural support system found in healthy, living tissue.
“It is important that the physical and mechanical properties of the dressing are very close to those of the skin“Said Mahmoudi. “To heal, the new cells must feel right at home”. Starting from this, the team can incorporate proteins, peptides and nanoparticles that not only stimulate the growth of new cells and blood vessels, but also fight bacteria by encouraging the patient’s immune system to join the charge.
It is important not to overlook the dressing that degrades over time, which means that no one should change or remove it and potentially aggravate the wound site. And at about $ 20 each, Mahmoudi believes the dressings, if and when approved by regulatory agencies, will be available to even resource-strapped health systems that need to treat chronic wounds.