2019 Fiscal Year Final Research Report

Study on establishment and clinical application of new peripheral blood flow index in ulcer lesion of severe ischemic limb

Research Project

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Project/Area Number	16K10647
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Cardiovascular surgery
Research Institution	Asahikawa Medical College
Principal Investigator	Akasaka Kazumi 旭川医科大学, 医学部, 講師 (80344555)
Co-Investigator(Kenkyū-buntansha)	藤井聡旭川医科大学, 医学部, 教授 (90291228)
Project Period (FY)	2016-04-01 – 2020-03-31
Keywords	重症虚血肢 / 微小循環評価 / 末梢血流 / 皮膚潰瘍 / マイクロRNA
Outline of Final Research Achievements	We experienced clinically improved cases of postoperative revascularization for critical limb ischemia, in which microcirculation evaluation by Superb Micro-vascular Imaging (SMI) and skin perfusion pressure (SPP) both confirmed improvement postoperatively. However, the blood flow display by SMI did not always agree with SPP. In the future, it will be necessary to display weaker blood flow with SMI, examine the measurement site suitable for SMI different from SPP, and cope with the disparity between subjects based on anatomical differences. It was also shown that microRNAs present in the exudates of ischemic ulcer lesions could be useful biomarkers to elucidate the pathophysiology of severe ischemic limb ulcers and to evaluate the validity of ulcer treatments. However, the relationship between microRNAs and SMI could not be clarified and future work is necessary. Elderly friendly testing of SMI and non-invasive sampling for ulcer microRNA are useful modalities in the aging society.
Free Research Field	循環器内科
Academic Significance and Societal Importance of the Research Achievements	末梢動脈疾患患者数は増加の一途であるが，糖尿病や維持透析患者においては，重症化してから専門医へ紹介されるために潰瘍治癒の長期化が課題となっている．近年はより低侵襲の治療が可能となったこともあり，SMIの活用による簡便な微小循環の非侵襲的評価と早期診断により下肢切断を避けることは，患者の日常生活動作維持のためにも，国民医療費抑制のためにも重要である．また，潰瘍病変の浸出液のマイクロRNA解析はバイオマーカーとして有用となり，虚血性潰瘍の病態の解明に役立つ可能性がある．患者の負担なく検体の採取が可能であり，高齢者などの虚血性潰瘍の治療戦略をたてる上で有用である．