# A Social Genomics Model to Explore Loneliness and Systemic Inflammation in an Older Adult Population with Chronic Venous Leg Ulcers

> **NIH NIH R21** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2021 · $189,733

## Abstract

PROJECT SUMMARY/ABSTRACT
In response to PA-17-493, Addressing Chronic Wound Trajectories Through Social Genomics Research (R21),
this application seeks to advance social genomics research by exploring psychosocial stressors, symptoms and
biomarkers in a chronic wound population. The most common type of chronic wound is a venous leg ulcer
(CVLU), which accounts for 70-80% of the 6.5 million wounds currently being treated in the U.S. at health care
costs approaching $25 billion. One of the most common psychosocial stressors is loneliness, which affects 68%
of individuals with CVLUs, negatively influencing social relationships and reducing quality of life.
Unfortunately, psychosocial stressors are rarely assessed or managed during clinical encounters, and may play
a predominant role in the chronic, non-healing state. Loneliness has been linked to systemic inflammation
through various molecular pathways such as the upregulation of inflammatory genes. Inflammation is also a
well-established biological pathway associated with poor healing suggesting inflammation is a common
molecular mechanism that underlies both loneliness and poor wound healing. However, the confluence of
loneliness and inflammation in a wound population has not been elucidated. Thus, we hypothesize that
substantially heightened inflammation is a common molecular mechanism with a distinct
profile that underlies both loneliness and poor wound healing in a chronic wound population
compared to a wound population without loneliness. In this application, using a social genomics
framework guided by the psychoneuroimmunology (PNI) paradigm and the conserved transcriptional response
to adversity (CTRA) model, the aims of our prospective observational longitudinal study are to: examine
whether psychosocial stressors (i.e., social isolation, social support) and symptoms (i.e., fatigue, pain,
depression, anxiety, sleep disturbance, reduced QOL) differ between lonely (L+) and non-lonely (L-) patients
with CVLUs using well-validated questionnaires; characterize a biomarker (chemotaxic factors, growth
factors, vascular damage and immune regulators) profile common to L+ and CLVU using well-established
RNA sequencing and PCR methods for whole blood samples; and, explore whether age and sex/psychological
stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker
profile, over a 3-month study period, collecting data at 3 time points during wound care. We will also explore
demographic and other variables such as age (60 – 74, ≥75 years), sex, chronic illnesses, cognition, health
status, functional activity, stigma, nutritional status, length of time to heal (healing trajectory), and wound
treatment type across the 3 time points. The long-term objective of this research to better understand
molecular mechanisms common to loneliness and inflammation towards development of a biopsychosocial
prognostic indicator of healing potential in persons with chronic w...

## Key facts

- **NIH application ID:** 10259779
- **Project number:** 5R21NR018930-02
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** Teresa J Kelechi
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $189,733
- **Award type:** 5
- **Project period:** 2020-09-09 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10259779

## Citation

> US National Institutes of Health, RePORTER application 10259779, A Social Genomics Model to Explore Loneliness and Systemic Inflammation in an Older Adult Population with Chronic Venous Leg Ulcers (5R21NR018930-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10259779. Licensed CC0.

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