Efficacy of stem cell therapy for burn wounds: a systematic review and meta-analysis of preclinical studies

Li, Yuan; Xia, Weidong; Merwe, Leanne Van der; Dai, Wentong; Lin, Cai

doi:10.1186/s13287-020-01839-9

Cited by 29 publications

(24 citation statements)

References 68 publications

(255 reference statements)

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“…This result leads to a better effectiveness occurring on a smaller area of the skin flap. Consistent with our finding, a previous meta-analysis concluded that in the application of stem cells to treat burn wounds, smaller burn wounds are more likely to heal effectively [ 62 ]. Overall, the application of stem cells to skin flaps has shown considerable efficacy regardless of the area of the flap.…”

Section: Discussionsupporting

confidence: 92%

Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

Jiang

Merwe

et al. 2021

Stem Cell Res Ther

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Background A skin flap is one of the most critical surgical techniques for the restoration of cutaneous defects. However, the distal necrosis of the skin flap severely restricts the clinical application of flap surgery. As there is no consensus on the treatment methods to prevent distal necrosis of skin flaps, more effective and feasible interventions to prevent skin flaps from necrosis are urgently needed. Stem therapy as a potential method to improve the survival rate of skin flaps is receiving increasing attention. Methods This review followed the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. Twenty studies with 500 animals were included by searching Web of Science, EMBASE, PubMed, and Cochrane Library databases, up until October 8, 2020. Moreover, the references of the included articles were searched manually to obtain other studies. All analyses were conducted using Review Manager V.5.3 software. Results Meta-analysis of all 20 studies demonstrated stem cell treatment has significant effects on reducing necrosis of skin flap compared with the control group (SMD: 3.20, 95% CI 2.47 to 3.93). Besides, subgroup analysis showed differences in the efficacy of stem cells in improving the survival rate of skin flaps in areas of skin flap, cell type, transplant types, and method of administration of stem cells. The meta-analysis also showed that stem cell treatment had a significant effect on increasing blood vessel density (SMD: 2.96, 95% CI 2.21 to 3.72) and increasing the expression of vascular endothelial growth factor (VEGF, SMD: 4.34, 95% CI 2.48 to 6.1). Conclusions The preclinical evidence of our systematic review indicate that stem cell-based therapy is effective for promoting early angiogenesis by up regulating VEGF and ultimately improving the survival rate of skin flap. In summary, small area skin flap, the administration method of intra-arterial injection, ASCs and MSCs, and xenogenic stem cells from humans showed more effective for the survival of animal skin flaps. In general, stem cell-based therapy may be a promising method to prevent skin flap necrosis.

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Section: Discussionsupporting

confidence: 92%

Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

Jiang

Merwe

et al. 2021

Stem Cell Res Ther

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“…The primary acquisition of AT-MSC is based on the manually procedure performed with the involvement of lipoaspirate fermentation technique [ 41 ]. The adipose tissue suitable for MSC isolation can be obtained either by skin flaps [ 42 ] or liposuction (LS) [ 43 ].…”

Section: Msc-therapy Of Noamentioning

confidence: 99%

Mesenchymal stromal/stem cells and their exosomes for restoration of spermatogenesis in non-obstructive azoospermia: a systemic review

et al. 2021

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Stem cells have been introduced as new promising therapeutic agents in treatment of degenerative diseases because of having high differentiation potential while maintaining the ability to self-replicate and retaining features of their source cells. Among different type of cell therapies, mesenchymal stromal/stem cell (MSC) therapy is being increasingly developed as a new way to treat structural defects that need to be repaired and regenerated. Non-obstructive azoospermia (NOA) is a reproductive disease in men that causes infertility in 10% of infertile men. Based on in vitro studies, MSCs from different tissue sources have been differentiated into germ cells or gamete progenitor cells by simple methods in both male and female. On the other hand, the therapeutic effects of MSCs have been evaluated for the treatment of NOA animal models created by chemical or surgical compounds. The results of these studies confirmed successful allotransplantation or xenotransplantation of MSCs in the seminiferous tubules. As well, it has been reported that exosomes secreted by MSCs are able to induce the process of spermatogenesis in the testes of infertile animal models. Despite numerous advances in the treatment of reproductive diseases in men and women with the help of MSCs or their exosomes, no clinical trial has been terminated on the treatment of NOA. This systematic review attempts to investigate the possibility of MSC therapy for NOA in men.

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“…Traditional skin wound healing includes four classic phases: haemostasis, inflammation, proliferation and maturation. A meta-analysis showed that stem cell therapy plays a biological role in wound healing, mainly through angiogenesis and anti-inflammatory actions [ 40 ]. HUVECs have offered an important in vitro model for the study of angiogenesis.…”

Section: Resultsmentioning

confidence: 99%

3D bioprinting of integral ADSCs-NO hydrogel scaffolds to promote severe burn wound healing

Tang

et al. 2021

Regenerative Biomaterials

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Severe burns are challenging to heal and result in significant death throughout the world. Adipose-derived mesenchymal stem cells (ADSCs) have emerged as a promising treatment for full-thickness burn healing but are impeded by their low viability and efficiency after grafting in vivo. Nitric oxide (NO) is beneficial in promoting stem cell bioactivity, but whether it can function effectively in vivo is still largely unknown. In this study, we bioprinted an efficient biological scaffold loaded with ADSCs and NO (3D-ADSCs/NO) to evaluate its biological efficacy in promoting severe burn wound healing. The integral 3D-ADSCs/NO hydrogel scaffolds were constructed via 3D bioprinting. Our results shown that 3D-ADSCs/NO can enhance the migration and angiogenesis of Human Umbilical Vein Endothelial Cells (HUVECs). Burn wound healing experiments in mice revealed that 3D-ADSCs/NO accelerated the wound healing by promoting faster epithelialization and collagen deposition. Notably, immunohistochemistry of CD31 suggested an increase in neovascularization, supported by the upregulation of vascular endothelial growth factor (VEGF) mRNA in ADSCs in the 3D biosystem. These findings indicated that 3D-ADSC/NO hydrogel scaffold can promote severe burn wound healing through increased neovascularization via the VEGF signalling pathway. This scaffold may be considered a promising strategy for healing severe burns.

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Efficacy of stem cell therapy for burn wounds: a systematic review and meta-analysis of preclinical studies

Cited by 29 publications

References 68 publications

Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

Mesenchymal stromal/stem cells and their exosomes for restoration of spermatogenesis in non-obstructive azoospermia: a systemic review

3D bioprinting of integral ADSCs-NO hydrogel scaffolds to promote severe burn wound healing

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