Insights Into Microbiome and Environmental Contributions to Sickle Cell Disease and Leg Ulcers Study (INSIGHTS Study)

Genetic Disease Clinical Trial

Official title: Insights Into Microbiome and Environmental Contributions to Sickle Cell Disease and Leg Ulcers

Status Recruiting

Clinical Trial Summary

Background:

• People with sickle cell disease and other blood disorders sometimes get chronic leg ulcers. These are wounds that develop on the skin and don t go away. Current treatments do not work very well, so researchers want to learn more about why the ulcers happen. They want to find out which bacteria may cause it, and if external factors play a role.

Objective:

• To study social and environmental factors of sickle cell disease and the causes of sickle cell disease leg ulcers.

Eligibility:

• People age 18 and older who have sickle cell disease or another red cell disorder, with or without an active leg ulcer.

Design:

• Participants will have a medical history and clinical evaluation. They will also have blood drawn.

• Participants will complete questionnaires about their life, health, environment, stress, and other topics.

• Participants may provide a small sample of hair.

• Participants will be asked to collect a small amount of saliva.

• Participants with leg ulcers will have their skin microbiome sampled. The microbiome is all of the microbes (bacteria and and/or fungi) and their genes in and on the body. Researchers will use swabs to collect skin samples. Photographs will be taken of the skin sample area.

• Some participants without leg ulcers also will have their skin microbiome sampled.

• Some participants who have their skin microbiome sampled will return for a second visit. At this visit, their microbiome will be resampled. It will take place more than 30 days after the first visit.

Clinical Trial Description

Leg ulcers are a serious and debilitating complication of sickle cell disease (SCD). This study will explore microbial, genomic, and environmental (social and physical) factors, that may influence the onset and progression of leg ulcer formation and delayed healing in individuals living with SCD. There is variation in the incidence and duration of SCD leg ulcers.

They are often very painful, resistant to treatment, and recurrent in nature. The etiology of SCD associated leg ulcers is unclear, and we hypothesize that predisposition to developing leg ulcers is multifactorial. This multisite study is an exploratory study of the microbiome and environment of individuals living with sickle cell disease leg ulcers. The study's objective is to identify triggers that may be integral in leg ulcer onset and progression. The central goal of this study is to obtain an improved understanding of the participants clinical phenotype, leg ulcer microbiome and the psychosocial and environmental factors that may impact this complication. To achieve these goals, we will: (1) characterize the leg skin microbiome of SCD participants living with and without leg ulcers within the United States and Sierra Leone; (2) collect and analyze psychosocial and physical environmental data of individuals with SCD without leg ulcers and with leg ulcers; (3) examine the psychosocial impact of leg ulcers on individuals with SCD by conducting a qualitative phase to explore the individual experiences to understand the physical function, stigma, and self-esteem associated with those with active, recurrent, or single-occurrence presentations of leg ulcers; and (4) explore what factors influence psychological resilience, to examine the relationship of psychological resilience to the health outcomes of an adult population living with sickle cell disease in the U.S. and in Sierra Leone. This will provide us the opportunity to understand the complexity of participants' health, health care experiences and quality of life. ;

Related Conditions & MeSH terms

• Anemia, Sickle Cell
• Genetic Disease
• Genetic Diseases, Inborn
• Genomics
• Leg Ulcer

• NCT number: NCT02156102
• Study type: Observational
• Source: National Institutes of Health Clinical Center (CC)
• Contact: Hasmin C Ramirez
• Phone: (301) 435-6817
• Email: hasmin.ramirez@nih.gov
• Status: Recruiting
• Start date: June 16, 2014
• Completion date: December 31, 2025