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Bosanquet, David C, Laloo, Ryan, Sanders, Andrew 
ORCID: 0000-0002-7997-5286, Ruge, Fiona, Lane, Jane, Morris, Ceri A, Jiang, Wen G and Harding, Keith G
(2021)
Sensitivity of the Wound Edge Gene Signature “WD14” in Responding to Clinical Change: A Longitudinal Cohort Study.
The International Journal of Lower Extremity Wounds.
ART 153473462110567.
doi:10.1177/15347346211056786
(In Press)
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11401 Bosanquet, Laloo, Sanders, Ruge, Lane, Morris, Jiang, Harding (2021) Sensitivity of the Wound Edge Gene Signature 'WD14' in Responding to Clinical Change - a longitudinal cohort study.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (511kB) | Preview |
Abstract
Introduction: Genetic prognostication of chronic wounds is one recognised method of early identification of clinical wound healing status in order to target rigorous and advanced treatment regimens to hard-to-heal wounds. The WounD14 (WD14) gene signature is a recently developed scoring tool, derived from genetic interrogation of wound edge biopsies. It has been shown to predict the propensity of chronic venous leg ulcers to heal. However, it is unknown how WD14 responds with time and to changes in clinical wound healing status. The aim of this pilot study was therefore to evaluate if changes in the clinical healing status of wounds were identified by WD14 gene signature changes. Methods: WD14 was developed through a process of gene screening, refining and subsequent validation in three separate patient cohorts. Validation was undertaken in 85 consecutive patients referred to a tertiary wound healing unit with chronic venous leg ulcers, who underwent a wound edge biopsy to interrogate for a ‘healing’ or ‘non-healing’ genotype. A smaller cohort of patients (18%) underwent a second biopsy, which comprises this pilot cohort reported herein. 12 weeks after the biopsy wounds were clinically assessed for healing status and compared to WD14 genotype. Results: Sequential biopsies and WD14 scores were obtained from 16 patients. WD14 gene signature predicted clinical wound healing status among this cohort at either visit (total analysis of 32 wound edge biopsies) with a positive predictive value (PPV) of 85.2% (95% CI 74.1% to 92.0%) and negative predictive value (NPV) of 80.0% (95% CI 34.2% to 96.9%). Six wounds altered their clinical status between the two visits; in this cohort WD14 has a PPV of 66.7% (95% CI 47.3% to 81.7%) and NPV of 100%. Conclusion: Although the WD14 gene signature did change with wound healing status, further and larger studies are required to clarify precisely the role of this gene signature and its ability to prognosticate accurately over time with wounds of differing clinical status.
| Item Type: | Article |
|---|---|
| Article Type: | Article |
| Uncontrolled Keywords: | Chronic wounds; Non-healing wounds; Genetic test; Gene transcript quantitation; Stratified therapies |
| Subjects: | R Medicine > RC Internal medicine |
| Divisions: | Schools and Research Institutes > School of Education and Science |
| Depositing User: | Anna Kerr |
| Date Deposited: | 15 Jul 2024 15:39 |
| Last Modified: | 15 Jul 2024 15:39 |
| URI: | https://eprints.glos.ac.uk/id/eprint/11401 |
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