FLAMES Team, Restore Institute, Inserm, Toulouse III Paul Sabatier University, 4Bis Av. H. Curien, 31100, Toulouse, France.
Department of Plastic and Reconstructive Surgery, Toulouse University Hospital, 1 Av. Pr.Jean Poulhès, 31400, Toulouse, France.
Biol Direct. 2024 Sep 29;19(1):85. doi: 10.1186/s13062-024-00534-6.
Skin healing is a complex and dynamic physiological process that follows mechanical alteration of the skin barrier. Under normal conditions, this complex process can be divided into at least three continuous and overlapping phases: an inflammatory reaction, a proliferative phase that leads to tissue reconstruction and a phase of tissue remodeling. Macrophages critically contribute to the physiological cascade for tissue repair. In fact, as the inflammatory phase progresses, macrophage gene expression gradually shifts from pro-inflammatory M1-like to pro-resolutive M2-like characteristics, which is critical for entry into the repair phase. A dysregulation in this macrophage' shift phenotype leads to the persistence of the inflammatory phase. Mesenchymal stromal cells and specifically the MSC-derived from adipose tissue (ADSCs) are more and more use to treat inflammatory diseases and several studies have demonstrated that ADSCs promote the wound healing thanks to their neoangiogenic, immunomodulant and regenerative properties. In several studies, ADSCs and macrophages have been injected directly into the wound bed, but the delivery of exogenous cells directly to the wound raise the problem of cell engraftment and preservation of pro-resolutive phenotype and viability of the cells. Complementary approaches have therefore been explored, such as the use of biomaterials enriched with therapeutic cell to improve cell survival and function. This review will present a background of the current scaffold models, using adipose derived stromal-cells and macrophage as therapeutic cells for wound healing, through a discussion on the potential impact for future applications in skin regeneration. According to the PRISMA statement, we resumed data from investigations reporting the use ADSCs and bioscaffolds and data from macrophages behavior with functional biomaterials in wound healing models. In the era of tissue engineering, functional biomaterials, that can maintain cell delivery and cellular viability, have had a profound impact on the development of dressings for the treatment of chronic wounds. Promising results have been showed in pre-clinical reports using ADSCs- and macrophages-based scaffolds to accelerate and to improve the quality of the cutaneous healing.
皮肤愈合是一个复杂而动态的生理过程，它遵循皮肤屏障的机械改变。在正常情况下，这个复杂的过程可以至少分为三个连续且重叠的阶段：炎症反应、导致组织重建的增殖阶段和组织重塑阶段。巨噬细胞对组织修复的生理级联反应至关重要。事实上，随着炎症阶段的进展，巨噬细胞的基因表达逐渐从促炎 M1 样向促修复 M2 样特征转变，这对于进入修复阶段至关重要。这种巨噬细胞表型转变的失调会导致炎症阶段的持续存在。间充质基质细胞，特别是来源于脂肪组织的间充质基质细胞（ADSCs），越来越多地被用于治疗炎症性疾病，并且多项研究表明 ADSCs 由于其新生血管、免疫调节和再生特性，促进了伤口愈合。在几项研究中，ADSCs 和巨噬细胞已直接注射到伤口床中，但将外源性细胞直接输送到伤口会引起细胞移植和保持促修复表型以及细胞活力的问题。因此，已经探索了补充方法，例如使用富含治疗细胞的生物材料来提高细胞存活率和功能。本综述将介绍当前支架模型的背景，使用脂肪来源的基质细胞和巨噬细胞作为治疗细胞用于伤口愈合，通过讨论其对皮肤再生未来应用的潜在影响。根据 PRISMA 声明，我们从报告使用 ADSCs 和生物支架以及巨噬细胞在伤口愈合模型中与功能生物材料相互作用的研究中恢复了数据。在组织工程时代，能够维持细胞输送和细胞活力的功能生物材料对慢性伤口治疗敷料的发展产生了深远的影响。使用基于 ADSCs 和巨噬细胞的支架加速和改善皮肤愈合的临床前报告取得了有希望的结果。
