UQ Centre for Clinical Research, The University of Queensland, Royal Brisbane & Women’s Hospital, Brisbane, QLD, Australia.
Exp Dermatol. 2013 May;22(5):307-10. doi: 10.1111/exd.12141.
In recent years, few stem cells have gained as much clinical notoriety as mesenchymal stem cells. Indeed, MSCs are already in use for a range of systemic inflammatory and autoimmune conditions that also affect the skin, such as acute and chronic graft versus host disease or lupus erythematosus. Most interestingly, these cells are able to improve skin wound healing in multiple preclinical models and few patient series. An additional potential of these cells is the delivery of missing structural elements in skin inherited disorders. However, we here contend that MSCs are not appropriate for cell replacement therapies in the context of wound healing. Indeed, engraftment of cells in the dermis is poor in the absence of irradiation and the observed effects seem mainly due to paracrine factors. In this viewpoint, we favour the hypothesis of a replete niche and competition with resident mesenchymal populations in the dermis not allowing the engraftment of newly delivered MSCs. Consequently, we propose that the benefit of MSCs may be at least in part reproduced by the growth factors or immunomodulatory molecules that they produce. In any case, the rapid progress in this field has allowed the emergence of important questions in skin biology that need to be addressed in parallel with the predictable future use of MSCs in the clinic.
近年来，间充质干细胞在医学领域获得了广泛关注。事实上，间充质干细胞已被用于治疗多种系统性炎症和自身免疫性疾病，这些疾病也会影响皮肤，如急性和慢性移植物抗宿主病或红斑狼疮。更有趣的是，这些细胞能够改善多种临床前模型和少数患者系列中的皮肤伤口愈合。这些细胞的另一个潜在用途是在皮肤遗传疾病中输送缺失的结构元素。然而，我们认为在伤口愈合的背景下，间充质干细胞不适合用于细胞替代疗法。实际上，在没有辐照的情况下，细胞在真皮中的植入效果很差，观察到的效果似乎主要归因于旁分泌因子。在这种观点下，我们赞成真皮中充满的生态位和与常驻间充质群体竞争的假说，这使得新输送的间充质干细胞无法植入。因此，我们提出间充质干细胞的益处至少部分可以通过它们产生的生长因子或免疫调节分子来复制。无论如何，该领域的快速进展使得皮肤生物学中出现了一些重要问题，这些问题需要与间充质干细胞在临床上的可预见未来应用同时得到解决。
