1 Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University , Utrecht, The Netherlands .
2 Department of Otorhinolaryngology, Erasmus MC University Medical Center , Rotterdam, The Netherlands .
Tissue Eng Part B Rev. 2018 Feb;24(1):37-52. doi: 10.1089/ten.TEB.2017.0142. Epub 2017 Aug 4.
Adipose tissue-derived stem cells (ASCs) are known to be tissue-healing promoters due to their cellular plasticity and secretion of paracrine factors. Cultured ASC sheets provide a novel method of ASC application and can retain ASCs at the targeted tissue. The purpose of this systematic review is to evaluate preclinical studies using ASC sheet transplantation therapy for promoting tissue healing. First, we searched databases to identify studies of ASC sheet therapy in different experimental animal models, and then determined the quality score of studies using SYRCLE's risk bias tool. A total of 18 included studies examined the role of ASC sheets on tissue healing and function in models for myocardial infarction, dilated cardiomyopathy, full-thickness skin wounds, hind limb ischemia, esophageal strictures, and oral ulcers. ASC sheet application after myocardial infarction improved survival rate, cardiac function, and capillary density and reduced the extent of fibrosis. Application of ASC sheets to a full-thickness skin wound decreased the wound size and stimulated wound maturation. In the hind limb ischemia model, ASC sheet application improved limb perfusion and capillary density, and decreased the amount of ischemic tissue and inflammation. ASC sheet application to mucosal wounds of the digestive tract accelerated wound healing and decreased the degree of stricture and fibrosis. Taken together, transplanted ASC sheets had a positive effect on tissue healing and reconstruction in these preclinical studies. The reported favorable effects of ASC sheet therapy in various tissue healing applications may be implemented in future translational studies. It is suggested that future preclinical animal model studies of ASC sheet therapy should concern standardization of culture techniques and investigate the mechanisms of action. In addition, clearly indicated experimental setups according to the SYRCLE's guidelines should improve study quality and validity.
脂肪组织来源的干细胞（ASCs）因其细胞可塑性和旁分泌因子的分泌而被认为是组织修复促进剂。培养的 ASC 片提供了一种新型的 ASC 应用方法，可以将 ASC 保留在靶向组织中。本系统评价的目的是评估使用 ASC 片移植治疗促进组织愈合的临床前研究。首先，我们搜索数据库以确定不同实验动物模型中 ASC 片治疗的研究，然后使用 SYRCLE 的风险偏倚工具确定研究的质量评分。共有 18 项纳入的研究检查了 ASC 片在心肌梗死、扩张型心肌病、全层皮肤伤口、后肢缺血、食管狭窄和口腔溃疡模型中对组织愈合和功能的作用。心肌梗死后应用 ASC 片可提高存活率、心功能和毛细血管密度，减少纤维化程度。全层皮肤伤口应用 ASC 片可减少伤口大小并刺激伤口成熟。在后肢缺血模型中，应用 ASC 片可改善肢体灌注和毛细血管密度，减少缺血组织和炎症的量。将 ASC 片应用于消化道的黏膜伤口可加速伤口愈合，减少狭窄和纤维化的程度。总之，移植的 ASC 片在这些临床前研究中对组织愈合和重建有积极作用。ASC 片治疗在各种组织愈合应用中的良好效果可能会在未来的转化研究中得到实施。建议未来的 ASC 片治疗临床前动物模型研究应关注培养技术的标准化，并研究其作用机制。此外，根据 SYRCLE 指南清楚表明的实验设置应提高研究质量和有效性。
