Sierra-Sánchez Álvaro, Montero-Vilchez Trinidad, Quiñones-Vico María I, Sanchez-Diaz Manuel, Arias-Santiago Salvador
Cell Production and Tissue Engineering Unit, Andalusian Network of Design and Translation of Advanced Therapies, Virgen de las Nieves University Hospital, Granada, Spain.
Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.
Front Cell Dev Biol. 2021 Mar 9;9:643125. doi: 10.3389/fcell.2021.643125. eCollection 2021.
Skin disease may be related with immunological disorders, external aggressions, or genetic conditions. Injuries or cutaneous diseases such as wounds, burns, psoriasis, and scleroderma among others are common pathologies in dermatology, and in some cases, conventional treatments are ineffective. In recent years, advanced therapies using human mesenchymal stem cells (hMSCs) from different sources has emerged as a promising strategy for the treatment of many pathologies. Due to their properties; regenerative, immunomodulatory and differentiation capacities, they could be applied for the treatment of cutaneous diseases. In this review, a total of thirteen types of hMSCs used as advanced therapy have been analyzed, considering the last 5 years (2015-2020). The most investigated types were those isolated from umbilical cord blood (hUCB-MSCs), adipose tissue (hAT-MSCs) and bone marrow (hBM-MSCs). The most studied diseases were wounds and ulcers, burns and psoriasis. At preclinical level, studies with mice and rats were the main animal models used, and a wide range of types of hMSCs were used. Clinical studies analyzed revealed that cell therapy by intravenous administration was the advanced therapy preferred except in the case of wounds and burns where tissue engineering was also reported. Although in most of the clinical trials reviewed results have not been posted yet, safety was high and only local slight adverse events (mild nausea or abdominal pain) were reported. In terms of effectiveness, it was difficult to compare the results due to the different doses administered and variables measured, but in general, percentage of wound's size reduction was higher than 80% in wounds, Psoriasis Area and Severity Index and Severity Scoring for Atopic Dermatitis were significantly reduced, for scleroderma, parameters such as Modified Rodnan skin score (MRSC) or European Scleroderma Study Group activity index reported an improvement of the disease and for hypertrophic scars, Vancouver Scar Scale (VSS) score was decreased after applying these therapies. On balance, hMSCs used for the treatment of cutaneous diseases is a promising strategy, however, the different experimental designs and endpoints stablished in each study, makes necessary more research to find the best way to treat each patient and disease.
皮肤病可能与免疫紊乱、外部侵害或遗传因素有关。损伤或皮肤疾病，如伤口、烧伤、银屑病和硬皮病等，是皮肤科常见的病症，在某些情况下，传统治疗方法无效。近年来，使用来自不同来源的人间充质干细胞（hMSCs）的先进疗法已成为治疗多种病症的一种有前景的策略。由于它们具有再生、免疫调节和分化能力，可应用于皮肤病的治疗。在本综述中，考虑到最近5年（2015 - 2020年），共分析了13种用作先进疗法的hMSCs。研究最多的类型是从脐带血（hUCB - MSCs）、脂肪组织（hAT - MSCs）和骨髓（hBM - MSCs）中分离出来的。研究最多的疾病是伤口和溃疡、烧伤和银屑病。在临床前水平，以小鼠和大鼠为主要动物模型进行研究，使用了多种类型的hMSCs。分析的临床研究表明，除伤口和烧伤采用组织工程治疗外，静脉注射细胞疗法是首选的先进疗法。尽管在大多数所综述的临床试验中结果尚未公布，但安全性较高，仅报告了局部轻微不良事件（轻度恶心或腹痛）。在有效性方面，由于给药剂量和测量变量不同，难以比较结果，但总体而言，伤口尺寸缩小百分比在伤口治疗中高于80%，银屑病面积和严重程度指数以及特应性皮炎严重程度评分显著降低，对于硬皮病，改良罗德南皮肤评分（MRSC）或欧洲硬皮病研究组活动指数等参数显示疾病有所改善，对于增生性瘢痕，应用这些疗法后温哥华瘢痕量表（VSS）评分降低。总的来说，hMSCs用于治疗皮肤病是一种有前景的策略，然而，每项研究中建立的不同实验设计和终点，使得有必要进行更多研究以找到治疗每个患者和疾病的最佳方法。
