Diabetic Lower Extremity Discarded Specimens

Initiated in 2019, this assesses the transcriptomic (RNA) and proteomic (protein) changes in single cells of the skin of diabetic patients with or without foot ulceration. A combined understanding of single cell transcriptome and proteome levels has the potential to greatly enhance our understanding in an agnostic way regarding the interaction of individual cells in the expression of various genes and production of proteins associated with wound healing. We propose to use an innovative CITE-seq approach that combines highly multiplexed protein marker detection with unbiased transcriptome profiling foot skin biopsies from healthy, non-DM subjects and DM patients with healed and non-healed DFU. Our main aim is to evaluate differences in gene expression in various cell types and how this translate to expression of specific protein markers. We hypothesize that diabetic patients with impaired wound healing will have aberrant gene and protein expression that will lead to a chronic inflammation stage that precludes linear progression to the next phases of wound healing.