Incontinence-associated dermatitis by infected urine: biological mechanisms and prevention strategies
| Project/Area Number |
19K24194
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| Research Category |
Grant-in-Aid for Research Activity Start-up
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| Allocation Type | Multi-year Fund |
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| Review Section |
0908:Society medicine, nursing, and related fields
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| Research Institution | The University of Tokyo |
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Principal Investigator |
KOUDOUNAS SOFOKLIS 東京大学, 大学院医学系研究科(医学部), 特任研究員 (70849968)
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| Project Period (FY) |
2019-08-30 – 2022-03-31
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| Project Status |
Granted (Fiscal Year 2020)
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| Budget Amount *help |
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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| Keywords | IAD / infected urine / urinary-incontinence / older patients / dermatitis / bacteria / rat |
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| Outline of Research at the Start |
IAD is a painful complication among elderly patients, leading to a reduced quality of life. Physiological urine does not lead to the development of IAD; however, infected urine is severely irritating and increases the risk of skin damage. How infected urine leads to the development of IAD has never been investigated. Therefore, this study aims to elucidate the histopathological/molecular mechanisms of IAD caused by infected urine in order to develop new nursing interventions for complete prevention of IAD and ultimately improve the patients’ quality of life.
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| Outline of Annual Research Achievements |
Last year, my research focused on developing an animal model of incontinence-associated dermatitis (IAD) due to urinary infections. I spent more than 6 months examining different conditions for maceration, bacterial application, and length of exposure (6hrs, 24hrs, 3days) in order to identify the best conditions to reproduce the symptoms of IAD in clinical practice. I conducted in vivo experiments with Sprague-Dawley rats and common uropathogens were grown in synthetic human urine (s-urine) supplemented with nutrients for bacterial growth.
Remarkably, my results demonstrated that skin areas exposed to bacteria developed an IAD-like erythematous response after 3 days of exposure which persisted for up to 5 days. These findings highlighted that it is possible to reproduce the irritant response of IAD due to urinary infections in experimental rats. Further work is needed to establish this clinically relevant IAD model for patients with urinary incontinence to study IAD pathophysiology, underlying molecular mechanisms and guide preventive strategies.
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| Current Status of Research Progress |
Current Status of Research Progress
4: Progress in research has been delayed.
Reason
Despite sufficient progress to identify the conditions for the novel IAD model, there was a significant delay due to the Covid-19 pandemic to investigate in depth the underlying mechanisms. This will be the main goal for this fiscal year.
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| Strategy for Future Research Activity |
Considering that the best conditions for this new IAD model have been determined, in vivo animal experiments will be conducted to investigate the skin physiology and the underlying histopathological and molecular mechanisms. For example, to understand physiological mechanisms the integrity of the skin will be assessed by recording skin surface pH as this is a critical parameter in IAD development and has been reported in clinical studies. Skin appearance
and morphology will be assessed macroscopically and by microscopic anatomical methods, respectively. Histology and immunohistological analysis
will be performed to reveal the changes in skin tissue structure in response to urine and bacteria. Real-time PCR will also be performed to reveal gene expression in damaged skin and identify the molecular pathway alterations in IAD. Together, these methods will decipher the mechanisms following exposure to bacteria and urine.
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Report
(2 results)
Research Products
(6 results)
