Use of a Social Genomics Model to Explore Loneliness and Systemic Inflammation in an Adult Population With Chronic Lower Extremity Ulcers

OBJECTIVE: To investigate associations among demographic data, gene expression, and psychosocial variables and characterize a biomarker panel of 18 proinflammatory gene transcripts for lonely individuals with chronic lower extremity wounds. METHODS: For this observational study, data and blood samples were collected from 38 individuals at baseline and week 4 follow-up while receiving wound care. Comparisons were made between individuals who identified as higher lonely (L+) ≥40 on the UCLA Loneliness Scale or less lonely (L-) ≤39. Validated measures were used for self-reported wound pain, pain interference, sleep disturbance, physical health, depression, and wound healing, and RNA sequencing was used for whole blood samples. RESULTS: Individuals in the L+ group showed significantly elevated expression of proinflammatory genes over the 2 study visits ( P =.010), with significant differences observed at both baseline and follow-up. Several wound characteristics were independently associated with elevated inflammatory gene expression, including wound healing ( P =.025) and self-reported wound pain ( P =.018). The L+ group elevation in inflammatory gene expression was robust to control for depressive symptoms and variations in leukocyte subset prevalence. More individuals in the L+ group lived alone, were single, had a lower socioeconomic status, larger wounds, were mildly depressed, and experienced pain interference with physical mobility. CONCLUSIONS: Understanding differences in the biomarker profile of lonely individuals with chronic wounds, along with assessment of covariates such as living alone, low socioeconomic status, depression, poor social support, reduced mobility, and pain that impairs daily functioning, could lead to targeted interventions to improve patient outcomes.