Grants Funded

Abstract
The diabetic foot ulcer (DFU) is the leading cause of nontraumatic lower limb amputations and currently, the only means of prevention includes education, aggressive surveillance, and mechanical offloading. Additionally, treatment after ulcer formation is limited by surgical options that are costly, and often fail. One therapeutic approach being explored for prevention of ulcer formation is through fat grafting, whereby a clinician extracts adipose tissue (fat) and reinjects it at the location of the plantar fat pad, the thinning area of the foot where DFUs form. Similarly, researchers have recently demonstrated that healthy adipose-derived stem cells (ADSCs) can be injected locally to promote healing in the setting of the diabetic wound, an environment known for poor healing. Unfortunately, diabetic fat tissue is a poor starting material to serve as a therapeutic, due to its reduced regenerative capacity.

Here, we propose the development of a point-of-care methodology that implements mechanical activation of ADSCs. This optimized therapeutic can be combined with autologous fat tissue and introduced into the plantar area to prevent DFU formation, or it can be injected directly into a DFU to speed the healing. Despite serving as the largest store of stem cells in the body, diabetic fat tissue known to have decreased stem cell populations with impaired regenerative capacity. We will build upon previous knowledge that mechanical processing of fat tissue can be used to stimulate inherent stem cell populations to create a therapeutic with improved reparative potential.

With this grant, we will optimize processing parameters to generate an autologous point-of-care therapeutic that maximizes CD34, a universal stem cell maker that correlates with fat graft retention. Additionally, we will identify the mechanical cues that yield the greatest proportion of Muse and DPP4/CD55 cells, populations crucial to diabetic wound healing. This award will allow us to test this optimized tissue in various in vivo and in vitro settings to establish safety and efficacy profiles, thus paving the way to a translational therapeutic that will be both cost-effective, and tailor-made to the individual patient. We believe that by the completion of this study, we will have sufficient data to begin a human clinical trial.

Biography
Dr. Derek Banyard is a surgeon-scientist in-training at the Center for Tissue Engineering in the Department of Plastic Surgery at the University of California, Irvine. He received a Bachelor of Arts in Cognitive Science at the University of Virginia, a Medical Degree from Meharry Medical College and a Masters of Business Administration at Vanderbilt University. Dr. Banyard has completed two years of general surgery training and has a robust record of clinical and biomedical research including postdoctoral research fellowships in head & neck tumor immunology and vascular remodeling at the University of Maryland Medical Center. At UCI, Dr. Banyard has focused his research on characterizing the regenerative potential of adipose tissue. His early work earned him a prestigious clinical fellowship with the California Institute for Regenerative Medicine. His innovative work has resulted in speaking invitations around the world and multiple awards including 1st place in the abstract competition at the American Association of Plastic Surgeons Aesthetica Super Symposium in Las Vegas, NV as well as Best Poster Presentation at the 7th Annual European Plastic Surgery Research Council in Hamburg, Germany. Dr. Banyard is married to Dr. Angela Williams, a physician for the Veterans Administration and together, they are committed to reducing the health disparities of underserved populations.