A. Baig1, A. Jacob1,3, S. Kaplan1, M. Akerman3, P. Wang1,2,3, A. Oropallo1,2 1Northwell Health,Surgery,Manhasset, NY, USA 2Hofstra Northwell School Of Medicine,Hempstead, NY, USA 3The Feinstein Institute For Medical Research,Manhasset, NY, USA 4Hofstra Northwell School Of Medicine,Hempstead, NY, USA
Introduction: It has been well established that many factors affect how quickly and effectively different wounds heal. We evaluated cold inducible RNA binding protein (CIRP), an inflammatory mediator that has been shown to be increased in patients with sepsis and suggested to be an outcome predictor in sepsis. We hypothesize that circulating levels of CIRP are associated with wound size and healing rates. There are no published data regarding the relationship of CIRP levels and wound healing
Methods: This study is a prospective study of individuals with venous stasis ulcers of at least 1 cm at the start of the study, with adequate vascular perfusion as measured by ankle brachial index (ABI). Exclusion criteria included: diabetes, suspicion of wound infection or osteomyelitis, immunosuppressants, and autoimmune connective tissue disorders. Patients were enrolled in the study for a total of 12 weeks. Patients’ blood was drawn weekly and CIRP level was measured using Western blot with wound measurements taken as well.
Results: Patients in our case series that met the exclusion and inclusion criteria, the CIRP levels decreased over time (n=4). We noticed a correlation between average primary wound size and average CIRP level. Multiple patients developed new wounds during the course of the 12 week period, and we noticed an increase in CIRP levels of those patients that correlated to the discovery of a new, separate wound. CIRP is a potential systemic inflammatory marker and the rise in CIRP levels in patients who developed a second wound is in accordance with our hypothesis. Using a mixed model repeated measures ANOVA, our sample size of four patients yielded a trend showing a decrease in CIRP across week 0 to week 11, but was not statistically significant (p=0.052). The data was also suggestive of a positive association between CIRP levels and wound size; as the wound size decreased over the weeks, the CIRP levels correspondingly decreased as well.
Conclusion: Although the results need to be further explored with a well-structured study using a larger sample size, initial results of using CIRP demonstrate a promising correlation between CIRP and wound measurement.