Stem Cell Facility (DBT-Centre of Excellence for Stem Cell Research), All India Institute of Medical Sciences, New Delhi, Delhi, 110029, India.
Indiana Center for Regenerative Medicine and Engineering, Indiana University Health Comprehensive Wound Center, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
J Mol Med (Berl). 2024 Dec;102(12):1425-1450. doi: 10.1007/s00109-024-02493-x. Epub 2024 Oct 2.
Wound healing, an intricate biological process, comprises orderly phases of simple biological processed including hemostasis, inflammation, angiogenesis, cell proliferation, and ECM remodeling. The regulation of the shift in these phases can be influenced by systemic or environmental conditions. Any untimely transitions between these phases can lead to chronic wounds and scarring, imposing a significant socio-economic burden on patients. Current treatment modalities are largely supportive in nature and primarily involve the prevention of infection and controlling inflammation. This often results in delayed healing and wound complications. Recent strides in regenerative medicine and tissue engineering offer innovative and patient-specific solutions. Mesenchymal stem cells (MSCs) and their secretome have gained specific prominence in this regard. Additionally, technologies like tissue nano-transfection enable in situ gene editing, a need-specific approach without the requirement of complex laboratory procedures. Innovating approaches like 3D bioprinting and ECM bioscaffolds also hold the potential to address wounds at the molecular and cellular levels. These regenerative approaches target common healing obstacles, such as hyper-inflammation thereby promoting self-recovery through crucial signaling pathway stimulation. The rationale of this review is to examine the benefits and limitations of both current and emerging technologies in wound care and to offer insights into potential advancements in the field. The shift towards such patient-centric therapies reflects a paradigmatic change in wound care strategies.
伤口愈合是一个复杂的生物学过程，包括止血、炎症、血管生成、细胞增殖和细胞外基质重塑等有序的生物学过程。这些阶段的转换可以受到全身或环境条件的影响。这些阶段之间的任何不及时的过渡都可能导致慢性伤口和瘢痕形成，给患者带来巨大的社会经济负担。目前的治疗方法主要是支持性的，主要包括预防感染和控制炎症。这往往导致愈合延迟和伤口并发症。再生医学和组织工程的最新进展为创新和个体化治疗提供了可能。间充质干细胞（MSCs）及其分泌组在这方面具有特别的重要性。此外，像组织纳米转染这样的技术可以实现原位基因编辑，这是一种无需复杂实验室程序的按需特定方法。3D 生物打印和细胞外基质生物支架等创新方法也有可能在分子和细胞水平上解决伤口问题。这些再生方法针对的是常见的愈合障碍，如过度炎症，从而通过关键信号通路的刺激促进自我恢复。本综述的目的是检查伤口护理中现有和新兴技术的优缺点，并为该领域的潜在进展提供见解。这种以患者为中心的治疗方法的转变反映了伤口护理策略的范式转变。
