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以压疮为重点的新型策略在慢性伤口管理中的应用:新视角。

Application of novel strategies in chronic wound management with focusing on pressure ulcers: new perspective.

作者信息

Razavi Zahra Sadat, Aliniay Sharafshadehi Shahrzad, Yousefi Mohammad Hasan, Javaheri Fatemeh, Rahimi Barghani Mahmoud Reza, Afkhami Hamed, Heidari Fatemeh

机构信息

Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.

Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

出版信息

Arch Dermatol Res. 2025 Jan 31;317(1):320. doi: 10.1007/s00403-024-03790-8.

Abstract

Invading blood cells, extracellular tissue, and soluble mediators all play important roles in the wound-healing process. There is a substantial global burden of disease and mortality attributable to skin defects that do not heal. About 1% to 2% of the population in industrialized nations suffers from chronic wounds that don't heal, despite healthcare breakthroughs; this condition is very costly, costing about $25 billion each year in the US alone. Amputation, infection (affecting as many as 25% of chronic wounds), sepsis, and dermal replacements are all consequences of conventional therapeutic approaches like growth factor therapy and diabetic foot ulcers account for 85% of lower limb amputations. Despite these obstacles, scientists are constantly looking for new ways to speed healing and close wounds. The unique immunomodulatory capabilities and multipotency of mesenchymal stem cells (MSCs) have made them a potential therapeutic choice in tissue engineering and regenerative medicine. Animal models of wound healing have shown that MSCs can speed up the process by as much as 40% through enhancing angiogenesis, modulating inflammation, and promoting fibroblast migration. Clinical trials provide more evidence of their effectiveness; for instance, one RCT found that, after 12 weeks, patients treated with MSCs had a 72% smaller wound size than those in the control group. This review offers a thorough examination of MSCs by combining the latest research with preclinical evidence. Highlighting their potential to transform treatment paradigms, it delves into their biological properties, how they work during regeneration and healing, and therapeutic usefulness in controlling chronic wounds.

摘要

侵入的血细胞、细胞外组织和可溶性介质在伤口愈合过程中都发挥着重要作用。皮肤缺损无法愈合导致了巨大的全球疾病负担和死亡率。尽管医疗技术取得了突破,但工业化国家约1%至2%的人口患有无法愈合的慢性伤口;这种情况成本非常高,仅在美国每年就花费约250亿美元。截肢、感染(多达25%的慢性伤口受影响)、败血症和皮肤替代都是生长因子治疗等传统治疗方法的后果,糖尿病足溃疡占下肢截肢的85%。尽管存在这些障碍,科学家们仍在不断寻找加速愈合和闭合伤口的新方法。间充质干细胞(MSCs)独特的免疫调节能力和多能性使其成为组织工程和再生医学中一种潜在的治疗选择。伤口愈合的动物模型表明,间充质干细胞可以通过促进血管生成、调节炎症和促进成纤维细胞迁移,将愈合过程加快多达40%。临床试验提供了更多关于其有效性的证据;例如,一项随机对照试验发现,12周后,接受间充质干细胞治疗的患者伤口大小比对照组小72%。本综述结合最新研究和临床前证据,对间充质干细胞进行了全面审视。强调了它们改变治疗模式的潜力,深入探讨了它们的生物学特性、在再生和愈合过程中的作用方式以及在控制慢性伤口方面的治疗效用。

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