Projects
Name
Study of the process of tissue repair in chronic diabetic foot ulcers. Application of an alternative treatment : bacteriotherapy
University
Universidad Nacional de Tucuman
Domain
Pathophysiology
Departement
Institute of Microbiology. Chair of Immunology Faculty of Biochemistry, Chemistry and Pharmacy. National University of Tucum
Head
Dra. Mar
Tutor
Dra. Mirta Rachid; Dra. Clara Silva; Dr. Luis Olea; Dra. Marcela Ortiz Mayor
Languages
Spanish and English
Duration
4 weeks
Availability
Cities/Months Jan Feb Mar Apr May Jun Jul Augt Sep Oct Nov Dec
No No No No No Yes Yes Yes Yes Yes Yes No
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Diabetes mellitus is one of the most important health problems because of their high prevalence and the enormous social and economic consequences it produces. Diabetic foot ulcers are caused by vascular, neurological and persistent and recurrent infections complications leading to a deficiency in the process of wound healing. Both inflammation and the healing process are altered, constituting one of the major complications in these patients. Amputations and hospitalizations due to diabetic foot ulcers are the biggest problem in the world. Although surgical debridement is the fastest and most effective to remove necrotic tissue, other therapies for the treatment of diabetic foot ulcers have been proposed, such as skin grafts, growth factors and hyperbaric oxygen therapy. So far there is no effective alternative treatment. In this project we propose study the cellular and molecular mechanisms by which topical application of a culture of Lactobacillus plantarum (bacteriotherapy) favors the development of granulation tissue and healing of ulcers. Students undertake the following techniques and laboratory methods: Clinical -studies: It will work with type 2 diabetic patients with presence of ulcers of the lower limbs with polymicrobial infections. The controls are orthopedic patients without any other pathology described. All provided by the unit of Orthopedics and Traumatology Surgery Hospital Angel C. Padilla of San Miguel de Tucuman. They will be selected after a comprehensive description of the history, in which the characteristics of the lesion and complete laboratory studies will be included. Foot ulcers will be classified according to the Wagner classification which is based on the depth and penetration of the ulcer, osteomyelitis and gangrene and the extent of necrotic tissue. PROPOSED ALTERNATIVE TREATMENT (bacteriotherapy) Treatment with Lactobacillus plantarum consist topical application , once a day , a log phase culture L. plantarum 105 / ml in MRS medium in a volume intended to cover any injury . Applications will be made for 20 consecutive days. Samples at time 0 (start of treatment) , day 10 and at the end of treatment (day 20) were taken. studies on the size of the wound area were made. Sample biopsies: Biopsies will be obtained under local anesthesia and were held: Studies bacteriological- anatomopatol
What is the aim of the project?
- Study some pathophysiologic mechanisms involved in the development of diabetic foot ulcers related to the inflammatory process and disruption of wound healing mechanism. - To investigate the cellular and molecular mechanisms by which treatment with L. plantarum (bacteriotherapy) favor the healing process and tissue repair in diabetic foot ulcers.
What techniques and methods are used?
Students undertake the following techniques and laboratory methods: Clinical -studies: It will work with type 2 diabetic patients with presence of ulcers of the lower limbs with polymicrobial infections. The controls are orthopedic patients without any other pathology described. All provided by the unit of Orthopedics and Traumatology Surgery Hospital Angel C. Padilla of San Miguel de Tucuman. They will be selected after a comprehensive description of the history, in which the characteristics of the lesion and complete laboratory studies will be included. Foot ulcers will be classified according to the Wagner classification which is based on the depth and penetration of the ulcer, osteomyelitis and gangrene and the extent of necrotic tissue. PROPOSED ALTERNATIVE TREATMENT (bacteriotherapy) Treatment with Lactobacillus plantarum consist topical application , once a day , a log phase culture L. plantarum 105 / ml in MRS medium in a volume intended to cover any injury . Applications will be made for 20 consecutive days. Samples at time 0 (start of treatment) , day 10 and at the end of treatment (day 20) were taken. studies on the size of the wound area were made. Sample biopsies: Biopsies will be obtained under local anesthesia and were held: Studies bacteriological- anatomopatológicos- immunohistochemistry studies: Study of Angiogenesis In vitro studies: polymorphonuclear circulating blood of patients receiving alternative treatment with L. plantarum be cocultured at different times and subsequently in the supernatant the expression of growth factors.
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
Students will have an active role in the research project receive theoretical and practical knowledge. This will allow them to develop a scientific background in the area of diabetic foot ulcers and their different treatments. They can also increase their knowledge on this issue and exchange information among medical students. All this will help them strengthen their academic training and apply their knowledge in the development of the area of scientific research clinic.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Students in a first stage will attend theoretical seminars on diabetic foot ulcers and tissue repair processes and conduct a literature search of the topic. In a second stage, they will attend the Service of Orthopedics and Traumatology Hospital Padilla of the city of San Miguel de Tucuman in which perform a part of research with patient care and implementation of the proposed project treatment. Then they attend the Immunology and Bacteriology laboratories of the Faculty of Biochemistry, Chemistry and Pharmacy of the National University of Tucuman. There participate in the research that will include bacteriological and immunological studies. Also, in connection with the Faculty of Medicine of the National University of Tucuman, students undertake an internship at the Laboratory of Pathology in which receive a training about the different techniques of immunohistochemistry.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster
- The student will prepare a presentation
- The student’s name will be mentioned in a future publication
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Students participating in this project must have a minimum knowledge about : pathology, biology, general microbiology.
Are there any legal limitations in the student’s involvement
No
Hours
6
Type of students accepted
This project accepts:
- Medical students
- Graduated students (less than 6 months)
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