Hocking Anne M
Department of Surgery and Institute for Stem Cell and Regenerative Medicine, University of Washington , Seattle, Washington.
Adv Wound Care (New Rochelle). 2012 Aug;1(4):166-171. doi: 10.1089/wound.2011.0294.
Mesenchymal stem cell (MSC) treatment of wounds results in accelerated wound closure, increased granulation tissue formation, and increased angiogenesis. These adult stem cells exert their therapeutic effects primarily by secreting soluble factors that regulate cellular responses to cutaneous injury.
There is an urgent need for novel therapies for the treatment of wounds with delayed healing. Current treatment options for chronic nonhealing wounds and burns are limited and not always effective, despite significant advances in wound care including application of bioengineered skin equivalents and growth factors.
BASIC/CLINICAL SCIENCE ADVANCES: The three target articles advance the field by addressing critical gaps in knowledge about MSC function and mechanism during wound healing. The first target article provides the first evidence that MSCs regulate macrophage phenotype in wounds. The second target article demonstrates that diabetes mellitus impairs the ability of MSCs to promote wound healing and this can be rescued by a novel lipid mediator deficit in diabetic wounds. The final target article reports that the surgical technique of tissue expansion is enhanced by MSCs.
MSC therapy suppresses inflammation in wounds and may be more effective when used in conjunction with other therapeutics that modulate the diabetic wound environment. It also shows potential as an adjunctive therapy for surgical tissue expansion.
MSCs represent promising emerging therapies for wounds with delayed healing such as chronic nonhealing wounds and burns.
间充质干细胞(MSC)治疗伤口可加速伤口愈合、增加肉芽组织形成并促进血管生成。这些成体干细胞主要通过分泌调节细胞对皮肤损伤反应的可溶性因子来发挥其治疗作用。
迫切需要新的疗法来治疗愈合延迟的伤口。尽管伤口护理取得了重大进展,包括应用生物工程皮肤替代物和生长因子,但目前慢性不愈合伤口和烧伤的治疗选择有限且并非总是有效。
基础/临床科学进展:三篇目标文章通过解决伤口愈合过程中MSC功能和机制方面的关键知识空白,推动了该领域的发展。第一篇目标文章提供了MSC调节伤口中巨噬细胞表型的首个证据。第二篇目标文章表明糖尿病会损害MSC促进伤口愈合的能力,而糖尿病伤口中一种新型脂质介质的缺乏可挽救这种能力。最后一篇目标文章报道MSC可增强组织扩张的手术技术。
MSC疗法可抑制伤口炎症,与调节糖尿病伤口环境的其他疗法联合使用时可能更有效。它还显示出作为手术组织扩张辅助疗法的潜力。
MSC代表了治疗愈合延迟伤口(如慢性不愈合伤口和烧伤)的有前景的新兴疗法。