Department of Nutrition, The Fourth Medical Center Affiliated to PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100037, China.
Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010110, China.
Stem Cell Res Ther. 2024 Nov 19;15(1):437. doi: 10.1186/s13287-024-04063-x.
BACKGROUND: Deep partial-thickness burns have a significant impact on both the physical and mental health of patients. Our previous study demonstrated human Umbilical Cord Mesenchymal stem cells (hUCMSCs) could enhance the healing of severe burns in small animal burn models, such as rats. Furthermore, our team has developed a deep partial-thickness burn model in Bama miniature pigs, which can be utilized for assessing drug efficacy in preclinical trials for wound healing. Therefore, this study further determine the optimal dosage of hUCMSCs in future clinical practice by comparing the efficacy of low-to-high doses of hUCMSCs on deep partial-thickness burn wounds in Bama miniature pigs. MATERIALS AND METHODS: The male Bama miniature pigs (N = 8, weight: 23-28 kg and length: 71-75 cm) were used to establish deep partial-thickness burn models, which used a continuous pressure of 1 kg and contact times of 35 s by the invented electronic burn instrument at 100℃ to prepare 10 round burn wounds with diameter of 5 cm according to our previous report. And then, 0 × 10^7, 1 × 10^7, 2 × 10^7, 5 × 10^7 and 1 × 10^8 doses of hUCMSCs were respectively injected into burn wounds of their corresponding groups. After treatment for 7, 14 and 21 days, the burned wound tissues were obtained for histological evaluation, including HE staining for histopathological changes, immunohistochemistry for neutrophil (MPO+) infiltration and microvessel (CD31+) quantity, as well as Masson staining for collagen deposition. The levels of inflammatory factors TNF-α, IL-1β, IL-10 and angiogenesis factors angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF), as well as collagen type-I/type-III of the wound tissues were quantified by ELISA. RESULTS: All of doses hUCMSCs can significantly increase wound healing rate and shorten healing time of the deep partial-thickness burn pigs in a dose-dependent manner. Furthermore, all of doses hUCMSCs can significantly promote epithelialization and decreased inflammatory reaction of wound, including infiltration of inflammatory cells and levels inflammatory factors. Meanwhile, the amounts of microvessel were increased in all of doses hUCMSCs group than those in the burn group. Furthermore, the collagen structure was disordered and partially necrotized, and ratios of collagen type-I and type-III were significantly decreased in burn group (4:1 in normal skin tissue), and those of all hUCMSCs groups were significantly improved in a dose-dependent manner. In a word, 1 × 10^8 dose of hUCMSCs could regenerate the deep partial-thickness burn wounds most efficaciously compared to other dosages groups and the burn group. CONCLUSION: This regenerative cell therapy study using hUCMSCs demonstrates the best efficacy toward a high dose, that is dose of 1 × 10^8 of hUCMSCs was used as a reference therapeutic dose for treating 20 cm deep partial-thickness burns wound in future clinical practice.
背景:深度部分厚度烧伤对患者的身心健康都有重大影响。我们之前的研究表明,人脐带间充质干细胞(hUCMSCs)可以增强小型动物烧伤模型(如大鼠)严重烧伤的愈合。此外,我们的团队已经在巴马小型猪中开发了深度部分厚度烧伤模型,可用于评估伤口愈合的临床前试验中的药物疗效。因此,本研究通过比较 hUCMSCs 低剂量与高剂量对巴马小型猪深度部分厚度烧伤创面的疗效,进一步确定未来临床实践中的最佳剂量。
材料和方法:雄性巴马小型猪(N=8,体重:23-28kg,体长:71-75cm)用于建立深度部分厚度烧伤模型,使用我们之前报道的发明的电子烧伤仪以 1kg 的连续压力和 35s 的接触时间在 100℃下制备 10 个直径为 5cm 的圆形烧伤创面。然后,将 0×10^7、1×10^7、2×10^7、5×10^7 和 1×10^8 个剂量的 hUCMSCs 分别注入相应组的烧伤创面。治疗 7、14 和 21 天后,获取烧伤组织进行组织学评估,包括 HE 染色观察组织病理学变化、免疫组化检测中性粒细胞(MPO+)浸润和微血管(CD31+)数量,以及 Masson 染色检测胶原蛋白沉积。通过 ELISA 定量检测创面组织中炎症因子 TNF-α、IL-1β、IL-10 和血管生成因子血管生成素-2(Ang-2)、血管内皮生长因子(VEGF)以及胶原蛋白 I/III 的水平。
结果:所有剂量的 hUCMSCs 均可显著增加深度部分厚度烧伤猪的创面愈合率,并呈剂量依赖性缩短愈合时间。此外,所有剂量的 hUCMSCs 均可显著促进创面的上皮化和减轻炎症反应,包括炎症细胞浸润和炎症因子水平。同时,所有 hUCMSCs 组的微血管数量均高于烧伤组。此外,烧伤组的胶原结构紊乱,部分坏死,胶原 I/III 比例明显降低(正常皮肤组织为 4:1),所有 hUCMSCs 组均呈剂量依赖性显著改善。总之,与其他剂量组和烧伤组相比,1×10^8 剂量的 hUCMSCs 对深度部分厚度烧伤创面的再生效果最佳。
结论:本研究采用 hUCMSCs 的再生细胞治疗表明,高剂量(即 1×10^8 的 hUCMSCs)效果最佳,可作为未来临床实践中治疗 20cm 深度部分厚度烧伤创面的参考治疗剂量。
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