Wound care is complicated. We all respond differently to the accidents, circumstances and conditions that require us to heal. In diabetics, for instance, the impaired healing that unfortunately comes with the condition brings a range of frightening consequences.
But Dr Christina Bursill, Chief Investigator of Vascular Health at the Centre for Nanoscale BioPhotonics, is teaming up with fellow researchers in South Australia to create a new frontier in wound care. They’re ready to begin work on Australia’s first general wound biobank, a collection of blood and tissue samples gathered from a range of diabetic wound types.
The wealth of data that will be generated by analysing the samples will be a game changer, offering informed insight into the best way to heal a wound and, in doing so, possibly save a limb or a life.
The biobank team, which includes a vascular surgeon and another wound care biologist alongside Dr Bursill, will have access to a 3D camera and a grant enabling full genomics and data analysis to help identify biomarkers and provide modelling on wound-healing outcomes. After an initial target of 300 samples, Bursill aims to have the collection swell to thousands from all over Australia.
The idea of a biobank is nothing new. A Western Australian team led by burns medicine pioneer Dr Fiona Wood is also gathering powerful data, and there’s a wealth of information available in the cancer space. Wound healing data for diabetic foot ulcers and for many types of wounds, however, is scarce; and the clinical approach has changed little in the past century.
One of the biggest challenges in creating therapies to promote better healing, says Dr Bursill, is that you’re working with one of the most complex physiological processes in the human body. ‘[Wound] healing requires the recruitment of a huge range of different cell types, they all have to come in these distinct stages. It doesn’t take a lot to throw the process off,’ she explains.
And individual variation is a further complicating factor. ‘People have different health backgrounds. They might have high cholesterol, diabetes, hypertension,’ Dr Bursill adds. ‘There is a lot of diversity in the individual, and then the wound-healing response is very different again. And, how patients respond to therapy is different.’
Dr Bursill’s work in atherosclerosis — understanding the fatty deposits in arteries that cause heart disease — and the potential for HDL cholesterol to promote the growth of blood vessels led to a powerful model of wound healing in mice and set her on an additional research path.
‘It wasn’t necessarily intentional, but I’ve really enjoyed it,’ she laughs. ‘And I think from coming into it this way, I can really see a huge need for improvement in wound healing.’
Collaboration with innovative teams at CNBP has put her in touch with developments that go well beyond the standard ‘peek under the dressing’ approach and point to a future promising individualised care for each patient. Smart bandage technology, for example, has the potential to remotely monitor wounds to promote recovery. CNBP tech may well be part of the mix powering the biobank analysis, too.
‘Because wounds are so varied and every person has different responses, what we need is more data so we can have more precision care. The only way you can do that — and cancer has done it successfully — is to have these biobanks of samples, so you can know all about their genome, their DNA, their proteomics,’ says Dr Bursill.
The science to power the wound biobank is advancing very quickly. Platforms that measure genes, proteins, metabolites, lipids and glycoproteins can characterise every single aspect of every cell within a wound, revealing the secrets that will, with machine learning analysis, predict more effective treatment.
‘You’ll have a patient, you’ll get a read-out of their wound — from a biopsy, although we hope eventually a blood test — and then you could say, “You need this. Because we have all this data to draw from and the computer is telling me that this will give you a better result.”’
While a biobank won’t make healing a less complex physiological process, finally knowing so much more about how it works will mean the world to the future of wound care.