Atlanta VA Medical Center receives grants to develop treatment therapies for PAD patients

January 2020

Dr. Luke Brewster

Emory vascular surgeon-scientist Luke P. Brewster, MD, PhD, MA, will apply two recent grants from the Department of Veterans Affairs to the Atlanta VA Medical Center to identifying promising rehabilitation and regenerative therapies for integration into novel treatments of patients with inadequate blood flow to their legs, termed peripheral arterial disease (PAD). This significant medical condition affects older patients and patients with kidney disease or diabetes, and current invasive and medical therapies fail to provide the restorative function patients need to walk normally and pain free.

"Together, these exciting projects seek to bring real world impact and solutions to our veterans, and could only be conducted in the manner they deserve with support and cooperation between Emory's Department of Surgery and the Atlanta VAMC," says Dr. Brewster.

For the Small Projects in Rehabilitation Research grant (SPiRE) from the VA Office of Rehabilitation Research and Development, Dr. Brewster will collaborate with Jarrod Call, PhD, associate professor in the Department of Kinesiology at the University of Georgia, on testing the impact of exercise therapy on the muscle strength of ischemic limbs. This award will deploy Dr. Brewster's unique model of muscle ischemia with exercise therapy to help prepare and identify which muscles are most improved and over what time intervals.

"We hope to maximize walking performance and the benefits walking can have on muscle regeneration under the type of ischemic conditions experienced by PAD patients," he says.

The second grant, a VA Biomedical Laboratory Research and Development (BLRD) Merit Award, will investigate a novel approach to the molecular repair of mesenchymal stem cells (MSCs) from veterans with PAD and diabetes for use in boosting regeneration of blood vessels and muscles. MSCs are adult stem cells traditionally found in the bone marrow.

As principal investigator for this grant, Dr. Brewster will collaborate with Levi Wood, PhD, assistant professor of the George W. Woodruff School of Mechanical Engineering at Georgia Tech and an expert in cell signaling pathways, and Nick Willett, PhD, assistant professor in Emory Orthopaedics, staff scientist at the Atlanta VAMC, and a specialist in skeletal muscle regeneration.

This study will test the ability of repaired diabetic MSCs from the host animal to promote better blood flow and muscle strength, and then demonstrate which endogenous cells from the host animal assist in this process. The ultimate goal is to develop an autologous cell therapy for diabetic patients, who are in dire need of regenerative therapies.

"This exciting collaboration will determine the optimal cell repair and cell delivery approaches for regenerative applications in ischemic tissue," Dr. Brewster says. "By better understanding how cell therapies work with pre-existing cells in host animals, we hope to provide more sustained and complete healing of ischemic tissues."