Stem cells derived from burned skin - The future of burn care

Abstract

BackgroundThermal injuries affect millions of adults and children worldwide and are associated with high morbidity and mortality. The key determinant for the survival of burns is rapid wound healing. Large wounds exceed intrinsic wound-healing capacities, and the currently available coverage materials are insufficient due to lack of cellularity, availability or immunological rejection.MethodsUsing the surgically debrided tissue, we isolated viable cells from burned skin. The isolated cells cultured in tissue culture dishes and characterized.FindingsWe report here that debrided burned skin, which is routinely excised from patients and otherwise considered medical waste and unconsciously discarded, contains viable, undamaged cells which show characteristics of mesenchymal skin stem cells. Those cells can be extracted, characterized, expanded, and incorporated into created epidermal-dermal substitutes to promote wound healing in immune-compromised mice and Yorkshire pigs without adverse side effects.InterpretationThese findings are of paramount importance and provide an ideal cell source for autologous skin regeneration. Furthermore, this study highlights that skin contains progenitor cells resistant to thermal stress.FundCanadian Institutes of Health Research # 123336. CFI Leader's Opportunity Fund: Project # 25407 National Institutes of Health 2R01GM087285-05A1. EMHSeed: Fund: 500463, A generous donation from Toronto Hydro. Integra© Life Science Company provided the meshed bilayer Integra© for porcine experiments.

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

“…Fourteen studies [ 16 , 28 , 29 , 37 – 39 , 41 , 44 – 50 ] used rats, six studies [ 17 , 30 , 40 , 42 , 43 , 51 ] used mice, and two studies [ 36 , 52 ] used minipigs. A total of 10 studies were conducted in China [ 29 , 30 , 37 , 39 , 40 , 43 , 47 – 49 , 51 ], 3 studies in Brazil [ 16 , 28 , 41 ], 3 studies in the USA [ 36 , 42 , 52 ], and 2 studies in Iran [ 38 , 45 ], whereas the remaining 4 were conducted in Pakistan [ 46 ], Egypt [ 44 ], Turkey [ 50 ], and Canada [ 17 ], respectively. Four studies [ 40 , 43 , 48 , 51 ] did not report burn degree and two [ 38 , 45 ] used second-degree burns, while the others used third-degree.…”

“…Four studies [ 40 , 43 , 48 , 51 ] did not report burn degree and two [ 38 , 45 ] used second-degree burns, while the others used third-degree. The cell types used for transplantation were mesenchymal stem cells (MSCs) [ 17 , 28 – 30 , 43 – 48 , 50 ], epidermal stem cells (ESCs) [ 40 , 51 ], hair follicle stem cells (HFSCs) [ 38 ], stromal vascular fraction (SVF) [ 36 , 52 ], and adipose-derived stem cells (ASCs) [ 16 , 37 , 39 , 41 , 42 , 49 ]. As for mesenchymal stem cells, they derived from umbilical cord [ 30 , 46 – 48 ], bone marrow [ 28 , 29 , 43 – 45 , 50 ], and burned tissue [ 17 ].…”

“…The cell types used for transplantation were mesenchymal stem cells (MSCs) [ 17 , 28 – 30 , 43 – 48 , 50 ], epidermal stem cells (ESCs) [ 40 , 51 ], hair follicle stem cells (HFSCs) [ 38 ], stromal vascular fraction (SVF) [ 36 , 52 ], and adipose-derived stem cells (ASCs) [ 16 , 37 , 39 , 41 , 42 , 49 ]. As for mesenchymal stem cells, they derived from umbilical cord [ 30 , 46 – 48 ], bone marrow [ 28 , 29 , 43 – 45 , 50 ], and burned tissue [ 17 ]. The types of transplant for cell therapy include xenogenic [ 28 , 30 , 41 – 43 , 45 – 48 ], allogeneic [ 16 , 29 , 37 – 40 , 44 , 50 , 51 ], and autologous [ 17 , 36 , 39 , 49 , 52 ].…”

“…As for mesenchymal stem cells, they derived from umbilical cord [ 30 , 46 – 48 ], bone marrow [ 28 , 29 , 43 – 45 , 50 ], and burned tissue [ 17 ]. The types of transplant for cell therapy include xenogenic [ 28 , 30 , 41 – 43 , 45 – 48 ], allogeneic [ 16 , 29 , 37 – 40 , 44 , 50 , 51 ], and autologous [ 17 , 36 , 39 , 49 , 52 ]. It is worth noting that one study [ 39 ] reported the use of allogeneic stem cells and xenogenic stem cells.…”

“…Subsequently, the formation of scar and contracture will lead to considerable decrease of joint activity, and even the loss of function [ 14 ]. Various healing drugs including DNA [ 15 ], stem cells [ 16 , 17 ], growth factors [ 18 , 19 ], and siRNA [ 20 ] have been pursued to promote burn wound repair and regeneration. Although there are various treatment options, there is no consensus yet on the best treatment for severe burns such as deep partial-thickness and full-thickness burns.…”