Touching Lives - June 2004
Team makes rapid progress on leg ulcers
The annual cost to the NHS for treating leg ulcers is estimated to be as high as £600million. Poor circulation is a common feature of leg ulcers and the resulting lack of oxygen and nutrient supply to the tissue (called ischaemia) has a profound effect on healing and maintenance of the skin.
With more than £84,000 from Action Medical Research, researchers based at the University of Bristol and Southmead Hospital, Bristol are investigating the causes of leg ulcers with the ultimate aim of developing new treatments for this distressing problem.
The study involves collecting tissue samples from patients with peripheral vascular disease (a narrowing of the arteries that supply blood to the legs) and comparing these with samples taken from disease-free individuals. The research team is making excellent progress and has completed the first year of the two-year project. They have found a previously unknown mechanism that accounts for the formation of leg ulcers.
Connective tissue provides the skin with mechanical strength and supports the activity of cells within the skin. A deficient blood supply can lead to a loss of existing connective tissue and its replacement with material that is weaker than normal, resulting in fragile skin that is at risk of ulceration.
The team is now looking at ways to correct these problems and the information gained from the study should aid the development of treatments to prevent leg ulcers. This project is due to end in 2005 and we await their findings with great interest.
Dr John Tarlton, who is heading the research, said, “Thanks to Action Medical Research, we now have a good understanding of how leg ulcers form in patients with poor circulation. The normally slow rate of connective tissue replacement — a balance between formation and destruction — is greatly increased in ‘at risk’ skin prone to ulceration. This, combined with production of a weaker connective tissue, results in fragile skin that breaks down with relatively minor trauma. ^The challenge now is in prevention, which requires understanding of how connective tissue cells respond to inadequate blood supply^.”