Do Mesenchymal Stem Cells Have a Role to Play in Cutaneous Wound Healing?

Pountos, Ippokratis; Panteli, Michalis; Georgouli, T.; Giannoudis, Peter V.

doi:10.4137/cttt.s12278

Cited by 3 publications

(2 citation statements)

References 83 publications

(105 reference statements)

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“…Hypertension can also occur following ESIs; a mean systolic blood pressure increase of 5 mmHg has been previously reported following ESIs [ 201 ]. Finally, corticosteroid administration represents a risk factor for wound complications postoperatively and poses an increased risk for infections [ 203 ]. ESIs are frequently performed prior to spinal surgery, either as a disgnostic tool or for pain management, but their contribution to complications of such procedures is currently unknown.…”

Section: Discussionmentioning

confidence: 99%

Safety of Epidural Corticosteroid Injections

et al. 2015

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Background and ObjectiveEpidural corticosteroid injections (ESIs) have been used for several decades and now represent the most common intervention performed for the management of back pain with a radicular component. However, several reports have presented devastating complications and adverse effects, which fuelled concerns over the risk versus clinical effectiveness. The authors offer a comprehensive review of the available literature and analyse the data derived from studies and case reports.MethodsStudies were identified by searching PubMed MEDLINE, Ovid MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Library to retrieve all available relevant articles. Publications from the last 20 years (September 1994 to September 2014) were considered for further analysis. Studies selected were English-language original articles publishing results on complications related to the technique used for cervical and lumbar ESIs. The studies had to specify the approach used for injection. All studies that did not fulfil these eligibility criteria were excluded from further analysis.ResultsOverall, the available literature supports the view that serious complications following injections of corticosteroid suspensions into the cervical and lumbar epidural space are uncommon, but if they occur they can be devastating.ConclusionsThe true incidence of such complications remains unclear. Direct vascular injury and/or administration of injectates intra-arterially represent a major concern and could account for the vast majority of the adverse events reported. Accurate placement of the needle, use of a non-particulate corticosteroid, live fluoroscopy, digital subtraction angiography, and familiarisation of the operator with contrast patterns on fluoroscopy should minimise these risks. The available literature has several limitations including incomplete documentation, unreported data and inherent bias. Large registries and well-structured observational studies are needed to determine the true incidence of adverse events and address the safety concerns.

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Section: Discussionmentioning

confidence: 99%

Safety of Epidural Corticosteroid Injections

et al. 2015

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“…Unlike traditional topical ointments where dosage is controlled by application frequency, MSCs applied to wounds alter their secreted biofactors in response to their environment. MSCs secrete growth factors that reduce inflammation and increase angiogenesis, collagen synthesis, and macrophage and fibroblast migration 5,24. Insulin delivery to chronic wounds is also a powerful healing agent 23,28.…”

Section: Introductionmentioning

confidence: 99%

Coencapsulation of ISCs and MSCs Enhances Viability and Function of both Cell Types for Improved Wound Healing

et al. 2019

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IntroductionWe previously demonstrated that insulin secreting cells (ISCs) accelerate healing of chronic wounds, and it is known that mesenchymal stem cells (MSCs) also accelerate wound healing. Here, we report that the combination of both cell types coencapsulated into a synthetic hydrogel dressing accelerates chronic wound healing 3 × faster than control and 2 × faster than each cell type delivered singly. Specifically, insulin released by ISCs activates the PI3/Akt pathway, which is vital to the function and survival of MSCs. MSCs in turn improve the viability and function of ISCs.Materials and MethodsMSCs and/or rat islet tumor RIN-m cells were encapsulated into polyethylene glycol diacrylate hydrogel sheets and applied to 1 cm2 full thickness excisional wounds on the dorsa of genetically diabetic male mice (BKS.Cg-m +/+Leprdb/J) in accordance with protocols approved by the Rutgers IACUC. Encapsulated cell viability was assessed using a LIVE/DEAD® Viability/Cytotoxicity Kit. Akt phosphorylation, insulin, VEGF, and TGF-β1 secretion were assessed by ELISA. Animals were sacrificed on postoperative days 14 and 28 and wound tissue was collected for histological and western blot analysis.ResultsISC:MSC combination groups had the highest levels of every secreted product and phosphorylated Akt, and closed wounds in 14 days, ISC-only or MSC-only groups closed wounds in 28 days, control groups closed wounds in 40 days. Further, ISC:MSC groups healed without intermediate scab or scar.ConclusionsCombining MSCs with ISCs results in a more robust healing response than singly delivered cells, warranting further investigation of coencapsulation for MSC therapies.

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Effect of methotrexate on bone and wound healing

Pountos

Giannoudis

2017

Expert Opinion on Drug Safety

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Methotrexate (MTX) is one of the most commonly used disease modifying drugs administered for wide spectrum of conditions. Through the expansion of the indications of MTX use, an increasing number of patients nowadays attend orthopaedic departments receiving this pharmacological agent. The aim of this manuscript is to present our current understanding on the effect of MTX on bone and wound healing. Areas covered: The authors offer a comprehensive review of the existing literature on the experimental and clinical studies analysing the effect of MTX on bone and wound healing. The authors also analyse the available literature and describe the incidence of complications after elective orthopaedic surgery in patients receiving MTX. Expert opinion: The available experimental data and clinical evidence are rather inadequate to allow any safe scientific conclusions on the effect of MTX on bone healing. Regarding wound healing, in vitro and experimental animal studies suggest that MTX can adversely affect wound healing, whilst the clinical studies show that lose-dose MTX is safe and does not affect the incidence of postoperative wound complications.

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Do Mesenchymal Stem Cells Have a Role to Play in Cutaneous Wound Healing?

Cited by 3 publications

References 83 publications

Safety of Epidural Corticosteroid Injections

Safety of Epidural Corticosteroid Injections

Coencapsulation of ISCs and MSCs Enhances Viability and Function of both Cell Types for Improved Wound Healing

Effect of methotrexate on bone and wound healing

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