Madison, Wis. From the Division of Plastic and Reconstructive Surgery and the Department of Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, and the University of Wisconsin Carbone Cancer Center.
Plast Reconstr Surg. 2010 Feb;125(2):510-516. doi: 10.1097/PRS.0b013e3181c722bb.
Chronic wounds remain a major challenge in modern medicine and represent a significant burden, affecting not only physical and mental health, but also productivity, health care expenditure, and long-term morbidity. Even under optimal conditions, the healing process leads to fibrosis or scar. One promising solution, cell therapy, involves the transplantation of progenitor/stem cells to patients through local or systemic delivery, and offers a novel approach to many chronic diseases, including nonhealing wounds. Mesenchymal stem cells are multipotent, adult progenitor cells of great interest because of their unique immunologic properties and regenerative potential. A variety of preclinical and clinical studies have shown that mesenchymal stem cells may have a useful role in wound-healing and tissue-engineering strategies and both aesthetic and reconstructive surgery. Recent advances in stem cell immunobiology can offer insight into the multiple mechanisms through which mesenchymal stem cells could affect underlying pathophysiologic processes associated with nonhealing mesenchymal stem cells. Critical evaluation of the current literature is necessary for understanding how mesenchymal stem cells could potentially revolutionize our approach to skin and soft-tissue defects and designing clinical trials to address their role in wound repair and regeneration.
慢性伤口仍然是现代医学的主要挑战，代表着巨大的负担，不仅影响身心健康，还影响生产力、医疗支出和长期发病率。即使在最佳条件下，愈合过程也会导致纤维化或疤痕。一种有前途的解决方案是细胞治疗，通过局部或全身给药将祖细胞/干细胞移植到患者体内，为许多慢性疾病（包括愈合不良的伤口）提供了一种新的治疗方法。间充质干细胞是多能的、成体祖细胞，由于其独特的免疫特性和再生潜力而备受关注。各种临床前和临床研究表明，间充质干细胞可能在伤口愈合和组织工程策略以及美容和重建外科中发挥有用作用。干细胞免疫生物学的最新进展可以深入了解间充质干细胞影响与愈合不良相关的潜在病理生理过程的多种机制。为了了解间充质干细胞如何可能彻底改变我们治疗皮肤和软组织缺陷的方法，并设计临床试验以解决它们在伤口修复和再生中的作用，有必要对现有文献进行批判性评估。
