a Hagey Laboratory for Pediatric Regenerative Medicine; Division of Plastic and Reconstructive Surgery, Department of Surgery , Stanford University School of Medicine , Stanford , CA , USA.
Expert Opin Biol Ther. 2019 Jun;19(6):575-585. doi: 10.1080/14712598.2019.1596257. Epub 2019 Apr 11.
Aberrant wound healing is a significant healthcare problem, posing a substantial burden on patients, their families, and the healthcare system. Existing treatment options remain only moderately effective and often fail to promote the closure of non-healing wounds in susceptible populations, such as aging and diabetic patients. Stem cell therapy has emerged as a promising treatment modality, with the potential to restore tissue to its pre-injured state. Of particular interest are mesenchymal stromal cells, which have been shown to accelerate wound healing by modulating the immune response and promoting angiogenesis.
This review provides an overview of wound healing and current methods for the management of chronic wounds, as well as the current state and considerations for optimizing stem cell therapy. Considerations include stem cell types, tissue source, donor selection, cell heterogeneity, delivery methods, and genetic engineering.
A growing body of evidence has shown that delivery of stem cells, particularly mesenchymal stromal cells, has the potential to effectively improve the rate and quality of wound healing. However, significant additional basic and clinical research must be performed to optimize cell therapy, such as further elucidation of the therapeutic mechanisms of stem cells and standardization of clinical trial guidelines.
异常的伤口愈合是一个重大的医疗保健问题，给患者、他们的家庭和医疗保健系统带来了巨大的负担。现有的治疗选择仍然只是中等有效，而且往往无法促进易感人群（如衰老和糖尿病患者）的非愈合伤口的闭合。干细胞疗法已经成为一种有前途的治疗方式，有可能通过调节免疫反应和促进血管生成来使组织恢复到受伤前的状态。特别引人关注的是间充质基质细胞，它已被证明可以通过调节免疫反应和促进血管生成来加速伤口愈合。
本综述提供了伤口愈合和慢性伤口管理的当前方法的概述，以及优化干细胞疗法的现状和考虑因素。考虑因素包括干细胞类型、组织来源、供体选择、细胞异质性、传递方法和基因工程。
越来越多的证据表明，干细胞的传递，特别是间充质基质细胞，有可能有效地提高伤口愈合的速度和质量。然而，必须进行大量额外的基础和临床研究，以优化细胞疗法，例如进一步阐明干细胞的治疗机制和标准化临床试验指南。
