Full Text PA-95-016

FAILURE TO HEAL:  CHRONIC WOUND HEALING IN THE SKIN

NIH GUIDE, Volume 24, Number 1, January 13, 1995

PA NUMBER:  PA-95-016

P.T. 34

Keywords: 
  Skin Diseases 
  Injury 


National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institute on Aging
National Institute of Child Health and Human Development
National Institute of General Medical Sciences
National Institute of Nursing Research

PURPOSE

The National Institute of Arthritis and Musculoskeletal and Skin
Diseases (NIAMS), National Institute on Aging (NIA), the National
Institute of Child Health and Human Development (NICHD), National
Institute of General Medical Sciences (NIGMS), and the National
Institute of Nursing Research (NINR) invite applications for research
on wounds that fail to heal, including decubitus (pressure) ulcers,
venous (stasis) ulcers and diabetic ulcers.  The purpose of this
Program Announcement is to encourage research investigations that
will provide new knowledge of the mechanisms of abnormal wound
healing and/or to apply new findings or interventions to the
treatment and prevention of chronic wounds in man.

HEALTHY PEOPLE 2000

The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This Program
Announcement (PA), Failure to Heal:  Chronic Wound Healing in the
Skin, is related to the priority  area of chronic disabling
conditions.  Potential applicants may obtain a copy of "Healthy
People 2000" (Summary Report:  Stock No. 017-001-00474-0 or "Healthy
People 2000" (Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-783-3238).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic and foreign for-profit and
non-profit organizations, public and private, such as universities,
colleges, hospitals, laboratories, units of State and local
governments, and eligible agencies of the Federal government.  Women
and minority investigators are encouraged to apply.  Foreign
institutions are not eligible for First Independent Research Support
and Transition (FIRST) (R29) awards.

MECHANISM OF SUPPORT

This PA will use the National Institutes of Health (NIH) individual
research project grant (R01), FIRST (R29) awards, and interactive
research project grant (IRPG) mechanisms.  The IRPG mechanism is
described in PA-94-086, NIH Guide, Vol. 23, No. 28, July 29, 1994.
The total project period for applications submitted in response to
the PA may not exceed five years.

RESEARCH OBJECTIVES

Background

In spite of recent advances in the basic mechanisms of wound healing,
knowledge of the factors involved in the development and treatment of
chronic wounds remains limited.  Future progress in the treatment of
chronic wounds will require greater understanding of their
pathogenesis and failure to heal.  These two aspects were the subject
of a Workshop sponsored by the Skin Diseases Interagency Coordinating
Committee of the National Institutes of Health held on January 10 and
11, 1993.  The Workshop brought together a multidisciplinary group of
scientists working in the field of wound repair.  A summary of this
Workshop was published in the Journal of Investigative Dermatology
(v.102, pp 125-7, 1994).  Identified below is a selection of the
areas covered in that Workshop that are relevant to this
solicitation.  This list is illustrative and not exclusive or
restrictive.

o  Cytokines and growth factors in wound healing
o  Keratinocyte migration in the wound bed
o  The chronic wound environment
o  Changes in composition of extracellular matrix with advancing age
o  Matrix degrading metalloproteinases in wound healing
o  Metabolic changes, both systemic and in the wound environment,
including changes as a consequence of chronic disease or disability
o  Local tissue hypoxia
o  Fibrin formation and removal in wound healing
o  Wound infection
o  Alterations in wound healing with advancing age, chronic disease
or disability
o  Characterizing risk factors for recurring wounds
o  Clinical therapeutics in wound healing and prevention of recurring
wounds
o  Factor affecting the rate of healing of decubitus ulcers, and
success of treatment

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN
SUBJECTS

It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations) which have
been in effect since 1990.  The new policy contains some new
provisions that are substantially different from the 1990 policies.
All investigators proposing research involving human subjects should
read the "NIH Guidelines For Inclusion of Women and Minorities as
Subjects in Clinical Research," which have been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513), and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.

Investigators may obtain copies from these sources or from the
program staff or contact persons listed below.  Program staff may
also provide additional relevant information concerning the policy.

APPLICATION PROCEDURES

Applications are to be submitted on the grant application form PHS
398 (rev. 9/91) and will be accepted at the standard application
deadlines as indicated in the application kit.  Application kits are
available from most institutional offices of sponsored research and
from the Office of Grants Information, Division of Research Grants,
National Institutes of Health, Westwood Building, Room 449, Bethesda,
MD 20892, telephone 301-710-0267.  The number and title of this
program announcement must be typed in item number 2a on the fact page
of the application.

The completed original and five permanent, legible copies of the PHS
398 form must be sent or delivered to:

Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**

REVIEW CONSIDERATIONS

Applications received under this program announcement will be
assigned to an appropriate Initial Review Group (IRG) in accordance
with established NIH Referral Guidelines.  The IRG, consisting
primarily of non-Federal scientific and technical experts, will
review the applications for scientific and technical merit in
accordance with standard NIH review procedures.  As part of the
initial merit review, a process (triage) may be used by the initial
review group in which applications will be determined to be
competitive or non-competitive based on their scientific merit.
Applications judged to be competitive will be discussed and be
assigned a priority score.  Applications determined non-competitive
will be withdrawn from further consideration and the Principal
Investigator and the official signing for the applicant organization
will be notified.  Notification of the review recommendations will be
sent to the applicant after the initial review.  Applications
recommended for further consideration and receiving sufficiently high
priority will receive a second-level review by an appropriate
National Advisory Council, whose review may be based on policy
considerations as well as scientific merit.

AWARD CRITERIA

Applications recommended by a National Advisory Council will be
considered for funding on the basis of overall scientific and
technical merit of the research as determined by peer review, program
needs and balance, and availability of funds.

INQUIRIES

Inquiries concerning this PA are encouraged.  The opportunity to
clarify any issues or questions from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Alan N. Moshell, M.D.
National Institute of Arthritis, Musculoskeletal and Skin Diseases
Natcher Building,Room 5AS-25L
45 Center Drive
Bethesda, MD  20892-6500
Telephone:  (301) 594-5017
FAX:  (301) 480-4543

Hilary D. Sigmon, Ph.D., R.N.
National Center of Nursing Research
Natcher Building, Room 3AN-12
45 Center Drive
Bethesda, MD  20892-6300
Telephone:  (301) 594-5970
FAX:  (301) 480-8260

David Finkelstein, Ph.D.
National Institute on Aging
Gateway Building, Room 2C231
Bethesda, MD  20892
Telephone:  (301) 496-6402
FAX:  (301) 402-0010

Danuta Krotoski, Ph.D.
National Center for Medical Rehabilitation Research
National Institute of Child Health and Human Development
Building 61E, Room 2A03
Bethesda, MD  20892
Telephone:  (301) 402-2242
FAX:  (301) 402-0832

Yvonne T. Maddox, Ph.D.
National Institute of General Medical Sciences
Natcher Building, Room 2AS-49H
45 Center Drive
Bethesda, MD  20892-6200
Telephone:  (301) 594-5560
FAX:  (301) 480-2802

Direct inquiries regarding fiscal matters to:

Mary Graham
National Institute of Arthritis, Musculoskeletal and Skin Diseases
Natcher Building, Room 5AS-49A
45 Center Drive
Bethesda, MD  20892-6500
Telephone:  (301) 594-3504
FAX:  (301) 480-5450

Sally A. Nichols
Grants Management Office
National Institute of Nursing Research
Natcher Building, Room 3AN-32
45 Center Drive
Bethesda, MD  20892-6300
Telephone:  (301) 594-6869
FAX:  (301) 480-8256

Carol Tippery
Grants Management Officer
National Institute of General Medical Science
Natcher Building, Room 2AN-24C
45 Center Drive
Bethesda, MD  20892-6200
Telephone:  (301) 594-5135
FAX:  (301) 480-1969

AUTHORITY AND  REGULATIONS

This program is described in the Catalog of Federal Domestic
Assistance No. 93.361.  Awards are made under authorization of the
Public Health Service Act, Title IV, Part A (Public Law 78-410, as
amended by Public Law 99-158, 42 USC 241 and 285) and administered
under PHS grants policies and Federal Regulations 42 CFR 52 and 45
CFR Part 74.  This program is not subject to the intergovernmental
review requirements of Executive Order 12372 or Health Systems Agency
review.

The Public Health Service strongly encourages all grant recipients to
provide a smoke-free workplace and promote the nonuse of all tobacco
products.  This is consistent with the PHS mission to protect and
advance the physical and mental health of the American people.

.

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