Choudhury Subholakshmi, Surendran Nidhi, Das Amitava
Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad, India.
Academy of Science and Innovative Research (AcSIR), Ghaziabad, India.
Wound Repair Regen. 2021 Sep;29(5):697-710. doi: 10.1111/wrr.12925. Epub 2021 May 10.
Skin regeneration has been a challenging clinical problem especially in cases of chronic wounds such as diabetic foot ulcers, and epidermolysis bullosa-related skin blisters. Prolonged non-healing wounds often lead to bacterial infections increasing the severity of wounds. Current treatment strategies for chronic wounds include debridement of wounds along with antibiotics, growth factors, and stem cell transplantation therapies. However, the compromised nature of autologous stem cells in patients with comorbidities such as diabetes limits the efficacy of the therapy. The discovery of induced pluripotent stem cell (iPSC) technology has immensely influenced the field of regenerative therapy. Enormous efforts have been made to develop integration-free iPSCs suitable for clinical therapies. This review focuses on recent advances in the methods and reprogramming factors for generating iPSCs along with the existing challenges such as genetic alterations, tumorigenicity, immune rejection, and regulatory hurdles for the clinical application of iPSCs. Furthermore, this review also highlights the benefits of using iPSCs for the generation of skin cells and skin disease modeling over the existing clinical therapies for skin regeneration in chronic wounds and skin diseases.
皮肤再生一直是一个具有挑战性的临床问题，尤其是在慢性伤口的情况下，如糖尿病足溃疡和大疱性表皮松解症相关的皮肤水疱。长期不愈合的伤口常常导致细菌感染，增加伤口的严重程度。目前慢性伤口的治疗策略包括伤口清创以及使用抗生素、生长因子和干细胞移植疗法。然而，糖尿病等合并症患者自体干细胞的受损特性限制了该疗法的疗效。诱导多能干细胞（iPSC）技术的发现对再生治疗领域产生了巨大影响。人们已经做出了巨大努力来开发适用于临床治疗的无整合iPSC。本综述重点关注生成iPSC的方法和重编程因子的最新进展，以及iPSC临床应用中存在的挑战，如基因改变、致瘤性、免疫排斥和监管障碍。此外，本综述还强调了与慢性伤口和皮肤疾病的现有皮肤再生临床疗法相比，使用iPSC生成皮肤细胞和皮肤疾病模型的益处。
