Rustad Kristine C, Gurtner Geoffrey C
Department of Surgery, Stanford University , Stanford, California.
Adv Wound Care (New Rochelle). 2012 Aug;1(4):147-152. doi: 10.1089/wound.2011.0314.
Mesenchymal stem cells (MSCs) have shown significant therapeutic potential in preclinical animal models of wound healing. However, the translation of MSC-based therapeutics to clinical practice has been delayed by questions including the mechanisms of MSC homing, engraftment, and ultimate function.
Experimental models of MSC-based wound therapies often involve intravenous injection of cells followed by sacrifice of animals at various time points and detection of MSCs in wounds by histological methods. However, this methodology is limited by its sampling of only specific tissue at a single time point and provides no information about how exogenously transplanted MSCs home to the wound environment.
BASIC/CLINICAL SCIENCE ADVANCES: Most systemically injected MSCs initially become entrapped within the lungs before migrating out to the liver and spleen in the normal state. When an injury is present, after the initial lung entrapment, MSCs migrate in response to inflammatory mediators and home to sites of wounding.
As MSC-based wound therapies continue to advance toward clinical trials, the availability of noninvasive methods to track cells after injection into patients affords the opportunity to monitor stem cell behavior post-transplantation.
MSCs have demonstrated great promise as an emerging therapeutic for wound management. However, further preclinical studies will be needed to elucidate the reparative mechanisms of these cells and to determine how to optimize their regenerative potential.
间充质干细胞（MSCs）在伤口愈合的临床前动物模型中已显示出显著的治疗潜力。然而，基于MSCs的治疗方法向临床实践的转化因包括MSCs归巢、植入和最终功能机制等问题而延迟。
基于MSCs的伤口治疗实验模型通常涉及静脉注射细胞，随后在不同时间点处死动物，并通过组织学方法检测伤口中的MSCs。然而，这种方法仅在单个时间点对特定组织进行采样，存在局限性，且无法提供关于外源性移植的MSCs如何归巢到伤口环境的信息。
基础/临床科学进展：在正常状态下，大多数经全身注射的MSCs最初会被困在肺部，然后迁移到肝脏和脾脏。当存在损伤时，在最初被困在肺部之后，MSCs会响应炎症介质而迁移并归巢到伤口部位。
随着基于MSCs的伤口治疗不断向临床试验推进，注射到患者体内后跟踪细胞的非侵入性方法的可用性为监测移植后干细胞行为提供了机会。
MSCs作为一种新兴的伤口管理治疗方法已展现出巨大的前景。然而，需要进一步的临床前研究来阐明这些细胞的修复机制，并确定如何优化它们的再生潜力。
