Stem Cells for Cutaneous Wound Healing

Abstract

Optimum healing of a cutaneous wound involves a well-orchestrated cascade of biological and molecular processes involving cell migration, proliferation, extracellular matrix deposition, and remodelling. When the normal biological process fails for any reason, this healing process can stall resulting in chronic wounds. Wounds are a growing clinical burden on healthcare systems and with an aging population as well as increasing incidences of obesity and diabetes, this problem is set to increase. Cell therapies may be the solution. A range of cell based approaches have begun to cross the rift from bench to bedside and the supporting data suggests that the appropriate administration of stem cells can accelerate wound healing. This review examines the main cell types explored for cutaneous wound healing with a focus on clinical use. The literature overwhelmingly suggests that cell therapies can help to heal cutaneous wounds when used appropriately but we are at risk of clinical use outpacing the evidence. There is a need, now more than ever, for standardised methods of cell characterisation and delivery, as well as randomised clinical trials.

Bioengineered corneal epithelial cell sheet from mesenchymal stem cells—A functional alternative to limbal stem cells for ocular surface reconstruction

“…Current therapeutic delivery of MSCs use intravenous injections expecting them to home at the injury site (Wang, Qu, & Zhao, ) or direct application to the wounded surface (Kirby, Mills, Cowin, & Smith, ). Reports suggest that homing of MSCs to target organs or sites is below 5% in case of systemic infusions (Kang, Shin, Ko, Jo, & Ra, ).…”

TGF-β1 Pretreatment Improves the Function of Mesenchymal Stem Cells in the Wound Bed

“…MSCs can be isolated and expanded with relative ease and their immunogenicity sets them as the ideal candidate for both autologous and allogeneic transplantation in wound healing (Bobis et al, 2006; Murphy et al, 2013). Both preclinical studies with animal models and clinical studies have demonstrated effectiveness of MSCs in accelerating chronic wound healing (Wu et al, 2007a; Jackson et al, 2012; Isakson et al, 2015; Kim et al, 2015; Kirby et al, 2015). MSCs added (topical delivery) or recruited (systemic delivery) to the wound bed are believed to participate in healing process by one of the following mechanisms: (1) releasing paracrine factors e.g., cytokines, and (2) differentiating into cell phenotypes e.g., keratinocytes, required for regeneration (Wu et al, 2007b; Chen et al, 2008; Sasaki et al, 2008; Kuo et al, 2016).…”

Adipose-Derived Regenerative Cell Therapy for Burn Wound Healing: A Comparison of Two Delivery Methods

“…Recent progress in regenerative medicine has demonstrated the potential of cellular therapy in improving the rate and quality of wound healing and tissue regeneration. 3,4 Specifically, the heterogeneous stromal vascular fraction (SVF) of adipose tissue is an attractive option for autologous cell-based therapy. [5][6][7] Indeed, SVF is an easily accessible and rich source of stem and regenerative cells, including endothelial cells, fibroblasts, smooth muscle cells, macrophages, and adiposederived stromal cells.…”

“…Several approaches (e.g., fibrin spray, systemic, local injection, topical delivery, and scaffold delivery) have been tested for delivery of stem/progenitor cells to acute and chronic wounds. 3,[21][22][23] In addition, from an efficacy and disease-impact perspective, it is important to define appropriate methods to successfully deliver cells. For instance, for applications wherein it is crucial to rapidly deliver cells to a large surface area, for example, for fragile patients with large burns, local injection may not be feasible or desirable as it is invasive and requires multiple injections around a large wound perimeter.…”